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Sample records for psychotic disorders efficacy

  1. Psychotic Disorders

    MedlinePlus

    ... severe mental disorders that cause abnormal thinking and perceptions. People with psychoses lose touch with reality. Two ... is sending you secret messages. Hallucinations are false perceptions, such as hearing, seeing, or feeling something that ...

  2. Efficacy and specificity of Social Cognitive Skills Training for outpatients with psychotic disorders

    PubMed Central

    Horan, William P.; Kern, Robert S.; Tripp, Cory; Hellemann, Gerhard; Wynn, Jonathan K.; Bell, Morris; Marder, Stephen R.; Green, Michael F.

    2014-01-01

    Psychosocial interventions that target social cognition show promise for enhancing the functional outcomes of people with psychotic disorders. This randomized controlled trial evaluated the efficacy and treatment-outcome specificity of a 24-session Social Cognitive Skills Training (SCST) that targets emotional processing, social perception, attributional bias, and mentalizing (or Theory of Mind). Sixty-eight stable outpatients with primary psychotic disorders were randomly assigned to one of four time- and group format-matched treatment conditions: (1) SCST, (2) computerized neurocognitive remediation, (3) standard illness management skills training, or (4) a Hybrid treatment that combined elements of SCST and neurocognitive remediation. The SCST group demonstrated greater improvements over time than comparison groups in the social cognitive domain of emotional processing, including improvement on measures of facial affect perception and emotion management. There were no differential benefits among treatment conditions on neurocognitive or clinical symptom changes over time. Results indicate that a targeted social cognitive intervention led to improvements in social cognition among outpatients with psychosis. Findings provide guidance for continued efforts to maximize the benefits of social cognitive interventions. PMID:21377168

  3. Brief psychotic disorder

    MedlinePlus

    ... of a more chronic psychotic condition, such as schizophrenia or schizoaffective disorder . Antipsychotic drugs can help decrease ... Freudenriech O, Weiss AP, Goff DC. Psychosis and schizophrenia. In: Stern TA, Rosenbaum JF, Fava M, et ...

  4. Brief psychotic disorder

    MedlinePlus

    ... display of psychotic behavior, such as hallucinations or delusions, which occurs with a stressful event. ... behavior False ideas about what is taking place (delusions) Hearing or seeing things that aren't real ( ...

  5. [Acute and transient psychotic disorders].

    PubMed

    Marneros, A; Pillmann, F; Haring, A; Balzuweit, S

    2000-04-01

    Psychotic disorders with acute onset, a dramatic and polymorphous symptomatology and rapid resolution have been described in different countries and by different psychiatric schools. They have been called cycloid psychosis, bouffée délirante, psychogenic psychosis or good prognosis schizophrenia. ICD-10 has given an operational definition under the name "acute and transient psychotic disorders" (F23). Their nosological status is unclear. The Halle-Study of acute and transient psychotic disorders (ATPD) has investigated in a prospective manner clinical, para-clinical features and course of illness in 42 patients with ATPD and matched controls with positive schizophrenia, bipolar schizoaffective disorders as well as mentally healthy patients with acute surgical conditions. First results of our study show that ATPD amount to 4% of psychotic in-patients, prefer female sex, show short prodromi, marked affective disturbances within the episode and much better outcome as schizophrenic psychoses according to psychopathological, social, psychological and biographical criteria. Though ATPD may still be an inhomogeneous group, their clinical delineation from schizophrenia seems justified. PMID:10907609

  6. [Psychotic disorders: special aspects in general practice].

    PubMed

    Kurmann, Julius

    2015-09-30

    In emergency situations the general practitioner is often the first professional contact psychotic patients have. The following article conveys basic knowledge about psychotic disorders and their clinical features typically seen in general practice. PMID:26422072

  7. Animistic thinking in psychotic versus conduct-disordered hospitalized adolescents.

    PubMed

    Atlas, J A; Miller, A L; Arsenio, W F

    1993-10-01

    25 adolescents showing a Psychotic-spectrum Disorder were compared with 24 adolescents showing Conduct Disorder on a task eliciting reasons for attributing life to an ambiguous pictorial stimulus (dough on a beach). Consistent with expectations from earlier research, the psychotic adolescents showed greater modes of animistic thinking (attributions of life to nonlife forms) than conduct-disordered youth, associated with theorized merging between self and the nonhuman environment. Implications are discussed. PMID:8234613

  8. Capgras Syndrome in First-Episode Psychotic Disorders

    PubMed Central

    Salvatore, Paola; Bhuvaneswar, Chaya; Tohen, Mauricio; Khalsa, Hari-Mandir K.; Maggini, Carlo; Baldessarini, Ross J.

    2014-01-01

    Background Misidentification phenomena, including the delusion of “imposters” named after Joseph Capgras, occur in various major psychiatric and neurological disorders but have rarely been studied systematically in broad samples of modern patients. This study investigated the prevalence and correlated clinical factors of Capgras phenomenon in a broad sample of patient-subjects with first-lifetime episodes of psychotic affective and non affective disorders. Methods We evaluated 517 initially hospitalized, first-episode psychotic-disorder patients for prevalence of Capgras phenomenon and its association with DSM-IV-TR diagnoses including schizophreniform, brief psychotic, unspecified psychotic, delusional, and schizoaffective disorders, schizophrenia, bipolar-I disorder and major depression with psychotic features, and with characteristics of interest including antecedent psychiatric and neurological morbidity, onset-type and presenting psychopathological phenomena, using standard bivariate and multivariate statistical methods. Results Capgras syndrome was identified in 73/517 (14.1%) patients (8.2%–50% across diagnoses). Risk was greatest with acute or brief psychotic disorders (schizophreniform [50%], brief [34.8%], or unspecified [23.9%] psychoses), intermediate in major depression (15%), schizophrenia (11.4%) and delusional disorder (11.1%), and lowest in bipolar-I (10.3%) and schizoaffective disorders (8.2%). Associated were somatosensory, olfactory and tactile hallucinations, Schneiderian (especially delusional perception), and cycloid features as described by Perris and Brockington including polymorphous psychotic phenomena, rapidly shifting psychomotor and affective symptoms, pan-anxiety, ecstasy, over-concern with death, and perplexity or confusion, as well as rapid-onset, but not sex, age, abuse-history, dissociative features, or indications of neurological disorders. Conclusions Capgras syndrome was prevalent across a broad spectrum of first

  9. Heritability estimates for psychotic symptom dimensions in twins with psychotic disorders.

    PubMed

    Rijsdijk, Frühling V; Gottesman, Irving I; McGuffin, Peter; Cardno, Alastair G

    2011-01-01

    Factor analysis of psychotic symptoms frequently results in positive, negative, and disorganized dimensions, but heritability estimates have not yet been reported. Symptom dimensions are usually only measured in individuals with psychotic disorders. Here, it is valuable to assess influences acting via liability to psychosis and independent modifying effects. We estimated heritability for psychotic symptom dimensions, taking account of these issues. Two-hundred-and-twenty-four probandwise twin pairs (106 monozygotic, 118 same-sex dizygotic), where probands had psychoses, were ascertained from the Maudsley Twin Register in London (1948-1993). Lifetime history of DSM-III-R psychotic disorder and psychotic symptom dimensions was assessed from clinical records and research interviews and rated using the Operational Criteria Checklist. Estimates of heritability and environmental components of variance in liability were made with structural equation modeling using a causal-contingent common pathway model adapted for ascertainment from a clinical register. Significant heritability was found for DSM-III-R psychotic disorder (h² = 90%, 95%CI 68-94%) and the disorganized symptom dimension (h² = 84%, 95%CI 18-93%). The heritability for the disorganized dimension remained significant when influences acting through liability to psychosis were set to zero, suggesting that some influences on disorganization are modifying factors independent of psychosis liability. However, the relative extent of modifying factors versus influences acting through psychosis liability could not be clearly determined. To our knowledge, this study provides the first formal evidence of substantive heritability for the disorganized symptom dimension, and suggests that genetic loci influencing disorganization in individuals with psychoses are in some cases different from loci that influence risk of psychotic disorders themselves. PMID:21184588

  10. Oxytocin and Social Cognition in Affective and Psychotic Disorders

    PubMed Central

    Perez-Rodriguez, M. Mercedes; Mahon, Katie; Russo, Manuela; Ungar, Allison K.; Burdick, Katherine E.

    2014-01-01

    Impairments in social cognition are now recognized as core illness features in psychotic and affective disorders. Despite the significant disability caused by social cognitive abnormalities, treatments for this symptom dimension are lacking. Here, we describe the evidence demonstrating abnormalities in social cognition in schizophrenia, major depressive disorder, and bipolar disorder, as well as the neurobiology of social cognition including the role of oxytocin. We then review clinical trials of oxytocin administration in psychotic and affective disorders and the impact of this agent on social cognition. To date, several studies have demonstrated that oxytocin may improve social cognition in schizophrenia; too few studies have been conducted in affective disorders to determine the effect of oxytocin on social cognition in these disorders. Future work is needed to clarify which aspects of social cognition may be improved with oxytocin treatment in psychotic and affective disorders. PMID:25153535

  11. The prodrome and clinical risk for psychotic disorders.

    PubMed

    Goulding, Sandra M; Holtzman, Carrie W; Trotman, Hanan D; Ryan, Arthur T; Macdonald, Allison N; Shapiro, Daniel I; Brasfield, Joy L; Walker, Elaine F

    2013-10-01

    The psychosis prodrome offers great promise for identifying neural mechanisms involved in psychotic disorders and offers an opportunity to implement empirical interventions to delay, and ultimately ameliorate, illness onset. This article summarizes the literature on individuals in the putatively prodromal phase of psychosis/deemed at clinical high risk (CHR) for psychosis onset. Standardized measurement and manifestation of the CHR syndromes are discussed, followed by empirical findings that highlight the psychological deficits and biological abnormalities seen in CHR syndromes and psychotic disorders. Current controversies surrounding the diagnosis of CHR syndromes and issues related to the treatment of CHR individuals are also presented. PMID:24012073

  12. Neuregulin 3 Knockout Mice Exhibit Behaviors Consistent with Psychotic Disorders.

    PubMed

    Hayes, Lindsay N; Shevelkin, Alexey; Zeledon, Mariela; Steel, Gary; Chen, Pei-Lung; Obie, Cassandra; Pulver, Ann; Avramopoulos, Dimitrios; Valle, David; Sawa, Akira; Pletnikov, Mikhail V

    2016-07-01

    Neuregulin 3 (NRG3) is a paralog of NRG1. Genetic studies in schizophrenia demonstrate that risk variants in NRG3 are associated with cognitive and psychotic symptom severity, and several intronic single nucleotide polymorphisms in NRG3 are associated with delusions in patients with schizophrenia. In order to gain insights into the biological function of the gene, we generated a novel Nrg3 knockout (KO) mouse model and tested for neurobehavioral phenotypes relevant to psychotic disorders. KO mice displayed novelty-induced hyperactivity, impaired prepulse inhibition of the acoustic startle response, and deficient fear conditioning. No gross cytoarchitectonic or layer abnormalities were noted in the brain of KO mice. Our findings suggest that deletion of the Nrg3 gene leads to alterations consistent with aspects of schizophrenia. We propose that KO mice will provide a valuable animal model to determine the role of the NRG3 in the molecular pathogenesis of schizophrenia and other psychotic disorders. PMID:27606322

  13. Filicide, attempted filicide, and psychotic disorders.

    PubMed

    Valença, Alexandre M; Mendlowicz, Mauro V; Nascimento, Isabella; Nardi, Antonio E

    2011-03-01

    The objective of the study was to describe and discuss the cases of two women who faced criminal charges, one for attempting to murder her three children and the other for killing her 1-year-old boy. After a forensic psychiatric assessment of their level of criminal responsibility, these patients were considered not guilty by reason of insanity and were committed to forensic mental hospitals. These two patients received a diagnosis of paranoid schizophrenia, according to the DSM-IV-TR criteria. In both cases, psychotic symptoms were present before the manifestation of violent behavior, in the form of persecutory delusions, auditory hallucinations, and pathological impulsivity. The investigation into cases of filicide may contribute powerfully to expand our understanding of motivational factors underlying this phenomenon and enhance the odds for effective prevention. PMID:21210804

  14. Schizoaffective disorders are psychotic mood disorders; there are no schizoaffective disorders.

    PubMed

    Lake, C Raymond; Hurwitz, Nathaniel

    2006-08-30

    Schizoaffective disorder (SA D/O), introduced in 1933 by Dr. Jacob Kasanin, represented a first, modest change in our concept about the diagnoses of psychotic patients away from the beliefs of E. Bleuler, i.e., that hallucinations and delusions define schizophrenia, and toward the recognition of a significant role for mood disorders. SA D/O established a connection between schizophrenia and mood disorders, traditionally considered mutually exclusive, a connection that has strengthened progressively toward the diagnostic unity of all three disorders. A basic tenet of medicine holds that if discrepant symptoms can be explained by one disease instead of two or more, it is likely there is only one disease. The scientific justification for SA D/O and schizophrenia as disorders distinct from a psychotic mood disorder has been questioned. The "schizo" prefix in SA D/O rests upon the presumption that the diagnostic symptoms for schizophrenia are disease specific. They are not, since patients with severe mood disorders can evince any or all of the "schizophrenic" symptoms. "Schizophrenic" symptoms mean "psychotic" and not any specific disease. These data and a very low interrater reliability for SA D/O suggest that the concepts of SA D/O and schizophrenia as valid diagnoses are flawed. Clinically SA D/O remains popular because it encompasses both schizophrenia and psychotic mood disorder when there is a diagnostic question. We present a review of the literature in table form based on an assignment of each article assigned to one of five categories that describe the possible relationships between SA D/O, schizophrenia and psychotic mood disorders. We conclude that the data overall are compatible with the hypothesis that a single disease, a mood disorder, with a broad spectrum of severity, rather than three different disorders, accounts for the functional psychoses. PMID:16857267

  15. Psychotic disorders in DSM-5 and ICD-11.

    PubMed

    Biedermann, Falko; Fleischhacker, W Wolfgang

    2016-08-01

    The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) was published by the American Psychiatric Association (APA) in 2013, and the Work Group on the Classification of Psychotic disorders (WGPD), installed by the World Health Organization (WHO), is expected to publish the new chapter about schizophrenia and other primary psychotic disorders in 2017. We reviewed the available literature to summarize the major changes, innovations, and developments of both manuals. If available and possible, we outline the theoretical background behind these changes. Due to the fact that the development of ICD-11 has not yet been completed, the details about ICD-11 are still proposals under ongoing revision. In this ongoing process, they may be revised and therefore have to be seen as proposals. DSM-5 has eliminated schizophrenia subtypes and replaced them with a dimensional approach based on symptom assessments. ICD-11 will most likely go in a similar direction, as both manuals are planned to be more harmonized, although some differences will remain in details and the conceptual orientation. Next to these modifications, ICD-11 will provide a transsectional diagnostic criterion for schizoaffective disorders and a reorganization of acute and transient psychotic and delusional disorders. In this manuscript, we will compare the 2 classification systems. PMID:27418328

  16. Velo-Cardio-Facial Syndrome and Psychotic Disorders

    PubMed Central

    Chow, Eva W.C.; Bassett, Anne S.; Weksberg, Rosanna

    2011-01-01

    Psychiatric disorders have been reported in over 10% of patients with velo-cardio-facial syndrome (VCFS) in long-term follow-up. To further explore the behavioral and psychiatric findings associated with VCFS in adulthood, detailed clinical histories of two patients—one with VCFS who developed a psychotic illness, and one with schizophrenia who was found to have dysmorphological features associated with VCFS—are described in the current report. The observed overlap of physical and psychiatric symptoms in these two patients suggests that VCFS and psychotic disorders may share a pathogenetic mechanism. This could be consistent with a contiguous gene model for VCFS and psychosis, suggesting chromosome 22q11 as a possible candidate region for genetic studies of schizophrenia. PMID:8074160

  17. Cognitive impairments in psychotic disorders: common mechanisms and measurement

    PubMed Central

    Barch, Deanna M; Sheffield, Julia M

    2014-01-01

    Decades of research have provided robust evidence of cognitive impairments in psychotic disorders. Individuals with schizophrenia appear to be impaired on the majority of neuropsychological tasks, leading some researchers to argue for a “generalized deficit”, in which the multitude of cognitive impairments are the result of a common neurobiological source. One such common mechanism may be an inability to actively represent goal information in working memory as a means to guide behavior, with the associated neurobiological impairment being a disturbance in the function of the dorsolateral prefrontal cortex. Here, we provide a discussion of the evidence for such impairment in schizophrenia, and how it manifests in domains typically referred to as cognitive control, working memory and episodic memory. We also briefly discuss cognitive impairment in affective psychoses, reporting that the degree of impairment is worse in schizophrenia than in bipolar disorder and psychotic major depression, but the profile of impairment is similar, possibly reflecting common mechanisms at the neural level. Given the recent release of the DSM-5, we end with a brief discussion on assessing cognition in the context of diagnosis and treatment planning in psychotic disorders. PMID:25273286

  18. Olfactory function in psychotic disorders: Insights from neuroimaging studies

    PubMed Central

    Good, Kimberley P; Sullivan, Randii Lynn

    2015-01-01

    Olfactory deficits on measures of identification, familiarity, and memory are consistently noted in patients with psychotic disorders relative to age-matched controls. Olfactory intensity ratings, however, appear to remain intact while the data on hedonics and detection threshold are inconsistent. Despite the behavioral abnormalities noted, no specific regional brain hypoactivity has been identified in psychosis patients, for any of the olfactory domains. However, an intriguing finding emerged from this review in that the amygdala and pirifom cortices were not noted to be abnormal in hedonic processing (nor was the amygdala identified abnormal in any study) in psychotic disorders. This finding is in contrast to the literature in healthy individuals, in that this brain region is strongly implicated in olfactory processing (particularly for unpleasant odorants). Secondary olfactory cortex (orbitofrontal cortices, thalamus, and insula) was abnormally activated in the studies examined, particularly for hedonic processing. Further research, using consistent methodology, is required for better understanding the neurobiology of olfactory deficits. The authors suggest taking age and sex differences into consideration and further contrasting olfactory subgroups (impaired vs intact) to better our understanding of the heterogeneity of psychotic disorders. PMID:26110122

  19. European Psychiatric Association (EPA) guidance on the quality of eMental health interventions in the treatment of psychotic disorders.

    PubMed

    Gaebel, Wolfgang; Großimlinghaus, Isabell; Kerst, Ariane; Cohen, Yoram; Hinsche-Böckenholt, Andrea; Johnson, Bert; Mucic, Davor; Petrea, Ionela; Rössler, Wulf; Thornicroft, Graham; Zielasek, Jürgen

    2016-03-01

    The main aim was to develop recommendations on eMental health interventions for the treatment of psychotic disorders. A systematic literature search on eMental health interventions was performed, and 24 articles about interventions in psychotic disorders were retrieved and systematically assessed for their quality. Studies were characterized by a large heterogeneity with regard to study type, sample sizes, interventions and outcome measures. Five graded recommendations were developed dealing with the feasibility of eMental health interventions, beneficial effects of psychoeducation, preliminary results of clinical efficacy, the need of moderation in peer support eMental health groups and the need to develop quality standards. PMID:26874958

  20. Psychotic disorder caused by traumatic brain injury.

    PubMed

    Fujii, Daryl E; Ahmed, Iqbal

    2014-03-01

    Psychosis is a rare and severe sequela of traumatic brain injury (TBI). This article assists clinicians in differential diagnosis by providing literature-based guidance with regard to use of the Diagnostic and Statistical Manual for Mental Disorders 5 criteria for this condition. This article also describes potential relationships between TBI and the development of a psychosis within the conceptualization of psychosis as a neurobehavioral syndrome. PMID:24529427

  1. Resilience in patients with psychotic disorder.

    PubMed

    Bozikas, V; Parlapani, E

    2016-01-01

    The recovery movement differentiated clinical, which is related to disorder's symptoms, from personal recovery, which is outlined by a subjectively defined wellness state, characterised by hope and self-management. Schizophrenia research has long focused on risk factors and symptoms. The recovery movement triggered a focus shift from psychopathology towards better adjustment and growth despite living with schizophrenia. The recovery movement flourished parallel with positive psychology, the scientific study of ordinary human strengths and virtues investigating human motives and potentials. Understanding of human strengths could contribute to prevention or lessening of psychiatric disorders' devastating consequences, since optimism, sense of personal control and many other positive processes promote psychological health. Lately, the concepts of positive psychology have been implemented in schizophrenia research. Positive self-appraisals moderated suicidal ideation, even when patients experienced high levels of hopelessness.1 Additionally, among other factors, better self-images, internal locus of control (i.e. the perception that events in one's life relate to one's actions) and emphasis on personal efforts predicted a more favourable outcome in functioning of unmedicated patients.2 The concept of "resilience" is closely related to positive psychology. The American Psychological Association defines resilience as ''the process of adapting well in the face of adversity, trauma, threats or significant sources of stress''. The concept of resilience includes rebound from adversity.3 Determinants of resilience include biological, psychological, social and cultural factors that interact in a complex manner. The major manifestations of personal resilience are social competence, problem solving, autonomy and sense of purpose.5 Personality strengths that relate to resilience include high self-esteem, extroversion and optimism. Internal assets and personal competencies

  2. Cannabis use and the risk of developing a psychotic disorder

    PubMed Central

    HALL, WAYNE; DEGENHARDT, LOUISA

    2008-01-01

    We briefly review the evidence that cannabis use in adolescence and young adulthood is a contributory cause of schizophreniform psychoses, by summarising longitudinal studies that: a) have examined relationships between cannabis use and the risk of psychosis or psychotic symptoms; and b) have controlled for potential confounders, such as other forms of drug use and personal characteristics that predict an increased risk of psychosis. There is now reasonable evidence from longitudinal studies that regular cannabis use predicts an increased risk of schizophrenia and of reporting psychotic symptoms. These relationships have persisted after controlling for confounding variables such as personal characteristics and other drug use. The relationships did not seem to be explained by cannabis being used to self-medicate symptoms of psychosis. A contributory causal relationship is biologically plausible because psychotic disorders involve disturbances in the dopamine neurotransmitter system with which the cannabinoid system interacts, as has been shown by animal studies and a human provocation study. We briefly explore the clinical and public health implications of the most plausible hypothesis, that cannabis use precipitates schizophrenia in persons who are vulnerable because of a personal or family history of schizophrenia. PMID:18560513

  3. Disconnection Between Amygdala and Medial Prefrontal Cortex in Psychotic Disorders.

    PubMed

    Mukherjee, Prerona; Sabharwal, Amri; Kotov, Roman; Szekely, Akos; Parsey, Ramin; Barch, Deanna M; Mohanty, Aprajita

    2016-07-01

    Distracting emotional information impairs attention more in schizophrenia (SCZ) than in never-psychotic individuals. However, it is unclear whether this impairment and its neural circuitry is indicative generally of psychosis, or specifically of SCZ, and whether it is even more specific to certain SCZ symptoms (eg, deficit syndrome). It is also unclear if this abnormality contributes to impaired behavioral performance and real-world functioning. Functional imaging data were recorded while individuals with SCZ, bipolar disorder with psychosis (BDP) and no history of psychotic disorders (CON) attended to identity of faces while ignoring their emotional expressions. We examined group differences in functional connectivity between amygdala, involved in emotional evaluation, and sub-regions of medial prefrontal cortex (MPFC), involved in emotion regulation and cognitive control. Additionally, we examined correlation of this connectivity with deficit syndrome and real-world functioning. Behaviorally, SCZ showed the worst accuracy when matching the identity of emotional vs neutral faces. Neurally, SCZ showed lower amygdala-MPFC connectivity than BDP and CON. BPD did not differ from CON, neurally or behaviorally. In patients, reduced amygdala-MPFC connectivity during emotional distractors was related to worse emotional vs neutral accuracy, greater deficit syndrome severity, and unemployment. Thus, reduced amygdala-MPFC functional connectivity during emotional distractors reflects a deficit that is specific to SCZ. This reduction in connectivity is associated with worse clinical and real-world functioning. Overall, these findings provide support for the specificity and clinical utility of amygdala-MPFC functional connectivity as a potential neural marker of SCZ. PMID:26908926

  4. Does Operational Diagnosis of Schizophrenia Significantly Impact Intellectual Deficits in Psychotic Disorders?

    ERIC Educational Resources Information Center

    Kitamura, H.; Shioiri, T.; Itoh, M.; Sato, Y.; Shichiri, K.; Someya, T.

    2007-01-01

    Background: Evidence suggests that, as a group, patients with schizophrenia have intellectual deficits that may precede the manifestation of psychotic symptoms; however, how successfully intelligence tests are able to discriminate schizophrenia from other psychotic disorders has yet to be investigated in detail. Methods: Using Wechsler Adult…

  5. Shared psychotic disorder and criminal responsibility: a review and case report of folie à trois.

    PubMed

    Joshi, Kaustubh G; Frierson, Richard L; Gunter, Tracy D

    2006-01-01

    We present a case of shared psychotic disorder involving three sisters who were successful in establishing an insanity defense on numerous felony charges in the South Carolina criminal court system. Two of the authors of this article were court-appointed examiners in this case. We then present a history of shared psychotic disorder, an overview of the use of this diagnosis in the defense of insanity, and a discussion of the disposition of individuals with "temporary insanity." Finally, we compare shared psychotic disorder, culturally based belief systems, and religious cults, with a focus on their common and contrasting characteristics. PMID:17185481

  6. A Review of Biomarkers in Mood and Psychotic Disorders: A Dissection of Clinical vs. Preclinical Correlates

    PubMed Central

    Brand, Sarel J.; Möller, Marisa; Harvey, Brian H.

    2015-01-01

    Despite significant research efforts aimed at understanding the neurobiological underpinnings of mood (depression, bipolar disorder) and psychotic disorders, the diagnosis and evaluation of treatment of these disorders are still based solely on relatively subjective assessment of symptoms as well as psychometric evaluations. Therefore, biological markers aimed at improving the current classification of psychotic and mood-related disorders, and that will enable patients to be stratified on a biological basis into more homogeneous clinically distinct subgroups, are urgently needed. The attainment of this goal can be facilitated by identifying biomarkers that accurately reflect pathophysiologic processes in these disorders. This review postulates that the field of psychotic and mood disorder research has advanced sufficiently to develop biochemical hypotheses of the etiopathology of the particular illness and to target the same for more effective disease modifying therapy. This implies that a “one-size fits all” paradigm in the treatment of psychotic and mood disorders is not a viable approach, but that a customized regime based on individual biological abnormalities would pave the way forward to more effective treatment. In reviewing the clinical and preclinical literature, this paper discusses the most highly regarded pathophysiologic processes in mood and psychotic disorders, thereby providing a scaffold for the selection of suitable biomarkers for future studies in this field, to develope biomarker panels, as well as to improve diagnosis and to customize treatment regimens for better therapeutic outcomes. PMID:26411964

  7. Default Mode Network Connectivity as a Function of Familial and Environmental Risk for Psychotic Disorder

    PubMed Central

    Peeters, Sanne C. T.; van de Ven, Vincent; Gronenschild, Ed H. B. M; Patel, Ameera X.; Habets, Petra; Goebel, Rainer; van Os, Jim; Marcelis, Machteld

    2015-01-01

    Background Research suggests that altered interregional connectivity in specific networks, such as the default mode network (DMN), is associated with cognitive and psychotic symptoms in schizophrenia. In addition, frontal and limbic connectivity alterations have been associated with trauma, drug use and urban upbringing, though these environmental exposures have never been examined in relation to DMN functional connectivity in psychotic disorder. Methods Resting-state functional MRI scans were obtained from 73 patients with psychotic disorder, 83 non-psychotic siblings of patients with psychotic disorder and 72 healthy controls. Posterior cingulate cortex (PCC) seed-based correlation analysis was used to estimate functional connectivity within the DMN. DMN functional connectivity was examined in relation to group (familial risk), group × environmental exposure (to cannabis, developmental trauma and urbanicity) and symptomatology. Results There was a significant association between group and PCC connectivity with the inferior parietal lobule (IPL), the precuneus (PCu) and the medial prefrontal cortex (MPFC). Compared to controls, patients and siblings had increased PCC connectivity with the IPL, PCu and MPFC. In the IPL and PCu, the functional connectivity of siblings was intermediate to that of controls and patients. No significant associations were found between DMN connectivity and (subclinical) psychotic/cognitive symptoms. In addition, there were no significant interactions between group and environmental exposures in the model of PCC functional connectivity. Discussion Increased functional connectivity in individuals with (increased risk for) psychotic disorder may reflect trait-related network alterations. The within-network “connectivity at rest” intermediate phenotype was not associated with (subclinical) psychotic or cognitive symptoms. The association between familial risk and DMN connectivity was not conditional on environmental exposure. PMID

  8. Hypothesis: grandiosity and guilt cause paranoia; paranoid schizophrenia is a psychotic mood disorder; a review.

    PubMed

    Lake, Charles Raymond

    2008-11-01

    Delusional paranoia has been associated with severe mental illness for over a century. Kraepelin introduced a disorder called "paranoid depression," but "paranoid" became linked to schizophrenia, not to mood disorders. Paranoid remains the most common subtype of schizophrenia, but some of these cases, as Kraepelin initially implied, may be unrecognized psychotic mood disorders, so the relationship of paranoid schizophrenia to psychotic bipolar disorder warrants reevaluation. To address whether paranoia associates more with schizophrenia or mood disorders, a selected literature is reviewed and 11 cases are summarized. Comparative clinical and recent molecular genetic data find phenotypic and genotypic commonalities between patients diagnosed with schizophrenia and psychotic bipolar disorder lending support to the idea that paranoid schizophrenia could be the same disorder as psychotic bipolar disorder. A selected clinical literature finds no symptom, course, or characteristic traditionally considered diagnostic of schizophrenia that cannot be accounted for by psychotic bipolar disorder patients. For example, it is hypothesized here that 2 common mood-based symptoms, grandiosity and guilt, may underlie functional paranoia. Mania explains paranoia when there are grandiose delusions that one's possessions are so valuable that others will kill for them. Similarly, depression explains paranoia when delusional guilt convinces patients that they deserve punishment. In both cases, fear becomes the overwhelming emotion but patient and physician focus on the paranoia rather than on underlying mood symptoms can cause misdiagnoses. This study uses a clinical, case-based, hypothesis generation approach that warrants follow-up with a larger representative sample of psychotic patients followed prospectively to determine the degree to which the clinical course observed herein is typical of all such patients. Differential diagnoses, nomenclature, and treatment implications are

  9. Hypothesis: Grandiosity and Guilt Cause Paranoia; Paranoid Schizophrenia is a Psychotic Mood Disorder; a Review

    PubMed Central

    Lake, Charles Raymond

    2008-01-01

    Delusional paranoia has been associated with severe mental illness for over a century. Kraepelin introduced a disorder called “paranoid depression,” but “paranoid” became linked to schizophrenia, not to mood disorders. Paranoid remains the most common subtype of schizophrenia, but some of these cases, as Kraepelin initially implied, may be unrecognized psychotic mood disorders, so the relationship of paranoid schizophrenia to psychotic bipolar disorder warrants reevaluation. To address whether paranoia associates more with schizophrenia or mood disorders, a selected literature is reviewed and 11 cases are summarized. Comparative clinical and recent molecular genetic data find phenotypic and genotypic commonalities between patients diagnosed with schizophrenia and psychotic bipolar disorder lending support to the idea that paranoid schizophrenia could be the same disorder as psychotic bipolar disorder. A selected clinical literature finds no symptom, course, or characteristic traditionally considered diagnostic of schizophrenia that cannot be accounted for by psychotic bipolar disorder patients. For example, it is hypothesized here that 2 common mood-based symptoms, grandiosity and guilt, may underlie functional paranoia. Mania explains paranoia when there are grandiose delusions that one's possessions are so valuable that others will kill for them. Similarly, depression explains paranoia when delusional guilt convinces patients that they deserve punishment. In both cases, fear becomes the overwhelming emotion but patient and physician focus on the paranoia rather than on underlying mood symptoms can cause misdiagnoses. This study uses a clinical, case-based, hypothesis generation approach that warrants follow-up with a larger representative sample of psychotic patients followed prospectively to determine the degree to which the clinical course observed herein is typical of all such patients. Differential diagnoses, nomenclature, and treatment implications

  10. Racial disparities in psychotic disorder diagnosis: A review of empirical literature

    PubMed Central

    Schwartz, Robert C; Blankenship, David M

    2014-01-01

    Psychotic disorder diagnoses are common in the United States and internationally. However, racial disparities in rates of psychotic disorder diagnoses have been reported across time and mental health professions. This literature review provides an updated and comprehensive summary of empirical research on race and diagnosis of psychotic disorders spanning a 24-year period. Findings reveal a clear and pervasive pattern wherein African American/Black consumers show a rate of on average three to four higher than Euro-American/White consumers. Latino American/Hispanic consumers were also disproportionately diagnosed with psychotic disorders on average approximately three times higher compared to Euro-American/White consumers. In addition, a trend among international studies suggests that immigrant racial minority consumers receiving mental health services may be assigned a psychotic disorder diagnosis more frequently than native consumers sharing a majority racial background. Potential explanations for this phenomenon are discussed, including possible clinical bias and sociological causes such as differential access to healthcare and willingness to participate in mental health services. Directions for future research should include the exploration of disproportionate diagnoses according to race through qualitative interviewing as well as empirical investigation. PMID:25540728

  11. Racial disparities in psychotic disorder diagnosis: A review of empirical literature.

    PubMed

    Schwartz, Robert C; Blankenship, David M

    2014-12-22

    Psychotic disorder diagnoses are common in the United States and internationally. However, racial disparities in rates of psychotic disorder diagnoses have been reported across time and mental health professions. This literature review provides an updated and comprehensive summary of empirical research on race and diagnosis of psychotic disorders spanning a 24-year period. Findings reveal a clear and pervasive pattern wherein African American/Black consumers show a rate of on average three to four higher than Euro-American/White consumers. Latino American/Hispanic consumers were also disproportionately diagnosed with psychotic disorders on average approximately three times higher compared to Euro-American/White consumers. In addition, a trend among international studies suggests that immigrant racial minority consumers receiving mental health services may be assigned a psychotic disorder diagnosis more frequently than native consumers sharing a majority racial background. Potential explanations for this phenomenon are discussed, including possible clinical bias and sociological causes such as differential access to healthcare and willingness to participate in mental health services. Directions for future research should include the exploration of disproportionate diagnoses according to race through qualitative interviewing as well as empirical investigation. PMID:25540728

  12. Assessing Social Networks in Patients with Psychotic Disorders: A Systematic Review of Instruments

    PubMed Central

    Priebe, Stefan

    2015-01-01

    Background Evidence suggests that social networks of patients with psychotic disorders influence symptoms, quality of life and treatment outcomes. It is therefore important to assess social networks for which appropriate and preferably established instruments should be used. Aims To identify instruments assessing social networks in studies of patients with psychotic disorders and explore their properties. Method A systematic search of electronic databases was conducted to identify studies that used a measure of social networks in patients with psychotic disorders. Results Eight instruments were identified, all of which had been developed before 1991. They have been used in 65 studies (total N of patients = 8,522). They assess one or more aspects of social networks such as their size, structure, dimensionality and quality. Most instruments have various shortcomings, including questionable inter-rater and test-retest reliability. Conclusions The assessment of social networks in patients with psychotic disorders is characterized by a variety of approaches which may reflect the complexity of the construct. Further research on social networks in patients with psychotic disorders would benefit from advanced and more precise instruments using comparable definitions of and timescales for social networks across studies. PMID:26709513

  13. Alcohol and Cannabis Use and Mortality in People with Schizophrenia and Related Psychotic Disorders

    PubMed Central

    Koola, Maju Mathew; McMahon, Robert P.; Wehring, Heidi J.; Liu, Fang; Mackowick, Kristen M.; Warren, Kimberly R.; Feldman, Stephanie; Shim, Joo-Cheol; Love, Raymond C.; Kelly, Deanna L.

    2012-01-01

    The impact of co-morbid substance use on mortality is not well studied in psychotic disorders. The objective of this study was to examine the impact of substance use on mortality in people with psychotic disorders and alcohol and/or drug use. We examined the rate of substance use and the risk of substance use on mortality risk over a 4–10 year period in 762 people with psychotic disorders. Deceased patients were identified from the Social Security Death Index and the Maryland Division of Vital Records. Substance use was defined as regular and heavy use or abuse or dependence. Seventy seven percent had co-morbid lifetime substance use, with co-morbid cannabis and alcohol use occurring most commonly. Out of 762 subjects, 62 died during follow up. In a Cox model, predicted mortality risk was higher in age group 35–55 compared to <35 years and in males, but reduced in cannabis users. Overall five- (3.1% vs 7.5%) and ten-year mortality risk (5.5% vs. 13.6%) was lower in cannabis users than in non-users with psychotic disorders (p=0.005) in a survival model. Alcohol use was not predictive of mortality. We observed a lower mortality risk in cannabis-using psychotic disorder patients compared to cannabis non-users despite subjects having similar symptoms and treatments. Future research is warranted to replicate these findings and to shed light on the anti-inflammatory properties of the endocannabinoid system and its role in decreased mortality in people with psychotic disorders. PMID:22595870

  14. Behavioral Response Inhibition in Psychotic Disorders: Diagnostic Specificity, Familiality and Relation to Generalized Cognitive Deficit

    PubMed Central

    Ethridge, Lauren E.; Soilleux, Melanie; Nakonezny, Paul A.; Reilly, James L.; Hill, S. Kristian; Keefe, Richard S. E.; Gershon, Elliot S.; Pearlson, Godfrey D.; Tamminga, Carol A.; Keshavan, Matcheri S.; Sweeney, John A.

    2014-01-01

    Difficulty inhibiting context-inappropriate behavior is a common deficit in psychotic disorders. The diagnostic specificity of this impairment, its familiality, and its degree of independence from the generalized cognitive deficit associated with psychotic disorders remain to be clarified. Schizophrenia, schizoaffective and bipolar patients with history of psychosis (n=523), their available first-degree biological relatives (n=656), and healthy participants (n=223) from the multi-site B-SNIP study completed a manual Stop Signal task. A nonlinear mixed model was used to fit logistic curves to success rates on Stop trials as a function of parametrically varied Stop Signal Delay. While schizophrenia patients had greater generalized cognitive deficit than bipolar patients, their deficits were similar on the Stop Signal task. Further, only bipolar patients showed impaired inhibitory control relative to healthy individuals after controlling for generalized cognitive deficit. Deficits accounted for by the generalized deficit were seen in relatives of schizophrenia and schizoaffective patients, but not in relatives of bipolar patients. In clinically stable patients with psychotic bipolar disorder, impaired inhibitory behavioral control was a specific cognitive impairment, distinct from the generalized neuropsychological impairment associated with psychotic disorders. Thus, in bipolar disorder with psychosis, a deficit in inhibitory control may contribute to risk for impulsive behavior. Because the deficit was not familial in bipolar families and showed a lack of independence from the generalized cognitive deficit in schizophrenia spectrum disorders, it appears to be a trait related to illness processes rather than one tracking familial risk factors. PMID:25261042

  15. [Synthetic Cannabinoid Receptor Agonist-Associated Psychotic Disorder: A Case Report].

    PubMed

    Sönmez, İpek; Köşger, Ferdi

    2016-01-01

    Synthetic cannabinoid receptor agonists (SCRA) has become one of the most abused substances, recently. JWH-018 street name known as Bonzai is one of the most abused substances in Turkish Republic of Northern Cyprus. The most common symptoms in cases reported with synthetic cannabis use are agitation, angry, paranoia and reference delusions, disorientation, seizure and nausea. Although the effects are very similar to cannabis, stimulant effects are more likely in SCRA use. In preparations containing SCRA do not contain cannabinidol agent which is reported to reduce the psychotic effects of the cannabis. This may explain the relationship between SCRA and psychotic disorders. We aimed to discuss a brief psychotic disorder associated with SCRA use and treatment which is less reported in the literature in this case report. PMID:27369687

  16. Genomewide Association Analyses of Electrophysiological Endophenotypes for Schizophrenia and Psychotic Bipolar Disorders: A Preliminary Report

    PubMed Central

    Hall, Mei-Hua; Chen, Chia-Yen; Cohen, Bruce M.; Spencer, Kevin M.; Levy, Deborah L.; Öngür, Dost; Smoller, Jordan W.

    2015-01-01

    Several event-related potentials (ERP), including P3, sensory gating (P50), and gamma oscillation, are robustly impaired in patients with schizophrenia (SCZ) and bipolar disorder (BIP). Although these ERPs are known to be heritable, little is known about the specific genetic loci involved and the degree to which they overlap with loci influencing mood and psychotic disorders. In the present study, we conducted GWAS to a) identify common variants associated with ERP endophenotypes, and b) construct polygenic risk scores (PRS) to examine overlap between genetic components of ERPs and mood and psychotic disorders. The sample consisted of 271 patients with SCZ or psychotic BIP diagnosis and 128 controls for whom ERP and genomewide data were available. GWAS were conducted using the full sample. PRS, derived from the Psychiatric Genomics Consortium (PGC) analyses of SCZ, BIP, and major depressive disorder were applied to each ERP phenotype. We identified a region on chromosome 14 that was significantly associated with sensory gating (peak SNP rs10132223, P = 1.27 × 10−9). This locus has not been previously associated with psychotic illness in PGC-GWAS. In the PRS analyses, patients with a higher load of SCZ risk alleles had reduced gamma response whereas patients with a higher load of BIP risk alleles had smaller P3 amplitude. We observed a genomewide significant locus on chromosome 14 for P50. This locus may influence P50 but not psychotic illness. Among patients with psychotic illness, PRS results indicated genetic overlap between SCZ loci and gamma oscillation and between BIP loci and P3 amplitude. PMID:25740047

  17. Reduced gray matter volume in psychotic disorder patients with a history of childhood sexual abuse.

    PubMed

    Sheffield, Julia M; Williams, Lisa E; Woodward, Neil D; Heckers, Stephan

    2013-01-01

    Childhood trauma is associated with smaller gray matter volume, similar to the pattern seen in psychotic disorders. We explored the relationship between childhood abuse, psychosis, and brain volume in a group of 60 individuals with a psychotic disorder and 26 healthy control subjects. We used voxel-based morphometry (VBM) to quantify gray and white matter volume and the Childhood Trauma Questionnaire (CTQ) to measure childhood abuse. Within the psychotic disorder group, total gray matter volume was inversely correlated with the severity of childhood sexual abuse (r=-.34, p=.008), but not the other types of abuse. When the 24 patients with sexual abuse were compared with demographically matched samples of 23 patients without sexual abuse and 26 control subjects, only patients with a history of sexual abuse had reduced total gray matter volume (t(48)=2.3, p=.03; Cohen's d=.63). Voxel-based analysis revealed a cluster in the prefrontal cortex where volume was negatively correlated with sexual abuse severity. Voxel based comparison of the three matched groups revealed a similar pattern of results, with widespread reductions in psychosis patients with sexual abuse relative to controls that were not found in psychosis patients without sexual abuse. These findings indicate that some of the variance of gray matter volume in psychotic disorders can be explained by a history of sexual abuse. PMID:23178105

  18. Psychotic Disorders in Learning Disabilities--Outcome of an Audit across Community Teams

    ERIC Educational Resources Information Center

    Varghese, Susan; Banerjee, Subimal

    2011-01-01

    The aim of the audit was to evaluate the current clinical practice for learning-disabled individuals with psychotic disorders. We evaluated the existing clinical practice in 910 individuals who were under the care of learning disability psychiatrists in Buckinghamshire (population of 480 000). This was compared with the National Institute for…

  19. Pharmacotherapy of Treatment-resistant Combat-related Posttraumatic Stress Disorder with Psychotic Features

    PubMed Central

    Pivac, Nela; Kozarić-Kovačić, Dragica

    2006-01-01

    Aim To assess retrospectively the clinical effects of typical (fluphenazine) or atypical (olanzapine, risperidone, quetiapine) antipsychotics in three open clinical trials in male Croatian war veterans with chronic combat-related posttraumatic stress disorder (PTSD) with psychotic features, resistant to previous antidepressant treatment. Methods Inpatients with combat-related PTSD were treated for 6 weeks with fluphenazine (n = 27), olanzapine (n = 28) risperidone (n = 26), or quetiapine (n = 53), as a monotherapy. Treatment response was assessed by the reduction in total and subscales scores in the clinical scales measuring PTSD (PTSD interview and Clinician-administered PTSD Scale) and psychotic symptoms (Positive and Negative Syndrome Scale). Results After 6 weeks of treatment, monotherapy with fluphenazine, olanzapine, risperidone, or quetiapine in patients with PTSD significantly decreased the scores listed in trauma reexperiencing, avoidance, and hyperarousal subscales in the clinical scales measuring PTSD, and total and subscales scores listed in positive, negative, general psychopathology, and supplementary items of the Positive and negative syndrome scale subscales, respectively (P<0.001). Conclusion PTSD and psychotic symptoms were significantly reduced after monotherapy with typical or atypical antipsychotics. As psychotic symptoms commonly occur in combat-related PTSD, the use of antipsychotic medication seems to offer another approach to treat a psychotic subtype of combat-related PTSD resistant to previous antidepressant treatment. PMID:16758523

  20. [Changes to Schizophrenia Spectrum and other psychotic disorders in DSM-5].

    PubMed

    Schultze-Lutter, Frauke; Schimmelmann, Benno G

    2014-05-01

    This article provides an overview of the main changes in the chapter "Schizophrenia Spectrum and Other Psychotic Disorders" from DSM-IV-TR to DSM-5, which, once again, does not make allowance for potential characteristics of children and adolescents. Changes in the main text include abandoning the classical subtypes of Schizophrenia as well as of the special significance of Schneider's first-rank symptoms, resulting in the general requirement of two key features (one having to be a positive symptom) in the definition of Schizophrenia and the allowance for bizarre contents in Delusional Disorders. Further introduced are the diagnosis of a delusional obsessive-compulsive/body dysmorphic disorder exclusively as Obsessive-Compulsive Disorder, the specification of affective episodes in Schizoaffective Disorder, and the formulation of a distinct subchapter "Catatonia" for the assessment of catatonic features in the context of several disorders. In Section III (Emerging Measures and Models) there is a recommendation for a dimensional description of psychoses. A likely source of confusion lies in the double introduction of an "Attenuated Psychosis Syndrome." On the one hand, a vague description is provided among "Other Specified Schizophrenia Spectrum and Other Psychotic Disorders" in the main text; on the other hand, there is a precise definition in Section III as a "Condition for Further Study." There is some cause to worry that this vague introduction of the attenuated psychosis syndrome in the main text might indeed open the floodgates to an overdiagnosis of subthreshold psychotic symptoms and their early pharmacological treatment. PMID:24846868

  1. Bilateral self-enucleation in acute transient psychotic disorder: the influence of sociocultural factors on psychopathology.

    PubMed

    Harish, Thippeswamy; Chawan, Namdev; Rajkumar, Ravi Philip; Chaturvedi, Santosh Kumar

    2012-07-01

    Self-inflicted eye injuries are rare but a devastating consequence of a serious mental disorder. Bilateral self-enucleation also known as oedipism has been documented in ancient texts and myths. Various biologic, psychologic, and social theories have been put forward to explain this rare phenomenon. In this report, we describe a case of oedipism, which highlights the influence of sociocultural factors on the psychopathology in acute transient psychotic disorder. PMID:21864835

  2. Semi-metric analysis of the functional brain network: Relationship with familial risk for psychotic disorder

    PubMed Central

    Peeters, Sanne; Simas, Tiago; Suckling, John; Gronenschild, Ed; Patel, Ameera; Habets, Petra; van Os, Jim; Marcelis, Machteld

    2015-01-01

    Background Dysconnectivity in schizophrenia can be understood in terms of dysfunctional integration of a distributed network of brain regions. Here we propose a new methodology to analyze complex networks based on semi-metric behavior, whereby higher levels of semi-metricity may represent a higher level of redundancy and dispersed communication. It was hypothesized that individuals with (increased risk for) psychotic disorder would have more semi-metric paths compared to controls and that this would be associated with symptoms. Methods Resting-state functional MRI scans were obtained from 73 patients with psychotic disorder, 83 unaffected siblings and 72 controls. Semi-metric percentages (SMP) at the whole brain, hemispheric and lobar level were the dependent variables in a multilevel random regression analysis to investigate group differences. SMP was further examined in relation to symptomatology (i.e., psychotic/cognitive symptoms). Results At the whole brain and hemispheric level, patients had a significantly higher SMP compared to siblings and controls, with no difference between the latter. In the combined sibling and control group, individuals with high schizotypy had intermediate SMP values in the left hemisphere with respect to patients and individuals with low schizotypy. Exploratory analyses in patients revealed higher SMP in 12 out of 42 lobar divisions compared to controls, of which some were associated with worse PANSS symptomatology (i.e., positive symptoms, excitement and emotional distress) and worse cognitive performance on attention and emotion processing tasks. In the combined group of patients and controls, working memory, attention and social cognition were associated with higher SMP. Discussion The results are suggestive of more dispersed network communication in patients with psychotic disorder, with some evidence for trait-based network alterations in high-schizotypy individuals. Dispersed communication may contribute to the clinical

  3. No evidence for attenuated stress-induced extrastriatal dopamine signaling in psychotic disorder

    PubMed Central

    Hernaus, D; Collip, D; Kasanova, Z; Winz, O; Heinzel, A; van Amelsvoort, T; Shali, S M; Booij, J; Rong, Y; Piel, M; Pruessner, J; Mottaghy, F M; Myin-Germeys, I

    2015-01-01

    Stress is an important risk factor in the etiology of psychotic disorder. Preclinical work has shown that stress primarily increases dopamine (DA) transmission in the frontal cortex. Given that DA-mediated hypofrontality is hypothesized to be a cardinal feature of psychotic disorder, stress-related extrastriatal DA release may be altered in psychotic disorder. Here we quantified for the first time stress-induced extrastriatal DA release and the spatial extent of extrastriatal DA release in individuals with non-affective psychotic disorder (NAPD). Twelve healthy volunteers (HV) and 12 matched drug-free NAPD patients underwent a single infusion [18F]fallypride positron emission tomography scan during which they completed the control and stress condition of the Montreal Imaging Stress Task. HV and NAPD did not differ in stress-induced [18F]fallypride displacement and the spatial extent of stress-induced [18F]fallypride displacement in medial prefrontal cortex (mPFC) and temporal cortex (TC). In the whole sample, the spatial extent of stress-induced radioligand displacement in right ventro-mPFC, but not dorso-mPFC or TC, was positively associated with task-induced subjective stress. Psychotic symptoms during the scan or negative, positive and general subscales of the Positive and Negative Syndrome Scale were not associated with stress-induced [18F]fallypride displacement nor the spatial extent of stress-induced [18F]fallypride displacement in NAPD. Our results do not offer evidence for altered stress-induced extrastriatal DA signaling in NAPD, nor altered functional relevance. The implications of these findings for the role of the DA system in NAPD and stress processing are discussed. PMID:25871972

  4. Longer-term outcome in the prevention of psychotic disorders by the Vienna omega-3 study.

    PubMed

    Amminger, G Paul; Schäfer, Miriam R; Schlögelhofer, Monika; Klier, Claudia M; McGorry, Patrick D

    2015-01-01

    Long-chain omega-3 polyunsaturated fatty acids (PUFAs) are essential for neural development and function. As key components of brain tissue, omega-3 PUFAs play critical roles in brain development and function, and a lack of these fatty acids has been implicated in a number of mental health conditions over the lifespan, including schizophrenia. We have previously shown that a 12-week intervention with omega-3 PUFAs reduced the risk of progression to psychotic disorder in young people with subthreshold psychotic states for a 12-month period compared with placebo. We have now completed a longer-term follow-up of this randomized, double-blind, placebo-controlled trial, at a median of 6.7 years. Here we show that brief intervention with omega-3 PUFAs reduced both the risk of progression to psychotic disorder and psychiatric morbidity in general in this study. The majority of the individuals from the omega-3 group did not show severe functional impairment and no longer experienced attenuated psychotic symptoms at follow-up. PMID:26263244

  5. Smoking and suicidality in patients with a psychotic disorder.

    PubMed

    Sankaranarayanan, Anoop; Mancuso, Serafino; Castle, David

    2014-03-30

    Cigarette smoking has been associated with an increased risk of suicide. Patients with psychosis are more likely to smoke cigarettes and are also at an increased risk of suicide. The aim of this study was to compare risk for suicidal behavior among patients with psychosis who were current smokers, previous smokers and nonsmokers. We studied 1812 of the 1825 participants who took part in the Australian Survey of High Impact Psychosis (SHIP) for whom smoking data was available. We identified predictors for lifetime suicide attempts using univariate logistic regression analysis. These variables were retained for the multiple logistic regression models if they were a significant predictor of lifetime suicide attempts. A series of multiple logistic regressions were then conducted to predict lifetime suicide attempts using current smoking status and lifetime smoking status as independent variables, respectively, while controlling for the retained predictor variables. Current smoking and lifetime smoking were statistically significant predictors of lifetime suicide attempts. However adding the covariates to a logistic regression model reduced this association to non-significance. The strongest predictors were self-harm in the past 12 months, the presence of lifetime depressive symptoms and a diagnosis of psychotic depression. Identification of suicide risk factors is essential for successful suicide prevention. While previous research highlights the importance of cigarette smoking as an important risk factor for suicidal behaviors including in patients with psychosis, these results must be interpreted within the context of methodological issues. PMID:24411712

  6. Evaluating differential developmental trajectories to adolescent-onset mood and psychotic disorders

    PubMed Central

    2013-01-01

    Background It is an open question as to whether differential developmental trajectories, potentially representing underlying pathophysiological processes, can form the basis of a more useful typology in young persons who present for mental health care. Methods A cohort of 605 young people was recruited from youth mental health services that target the early phases of anxiety, mood or psychotic disorders. Participants were assigned to one of three clinical sub-types (anxious-depression; mania-fatigue; developmental-psychotic) according to putative developmental trajectories. Results The distribution of subtypes was: 51% anxiety-depression, 25% mania-fatigue and 24% developmental-psychotic, with key differences in demographic, clinical, family history and neuropsychological characteristics. When analyses were limited to 286 cases with ‘attenuated’ or sub-threshold syndromes, the pattern of differences was similar. Multinomial logistic regression demonstrated that compared to the developmental-psychotic subtype, both the mania-fatigue and anxiety-depression subtypes were younger and more depressed at presentation, but less functionally impaired. Other discriminating variables between the developmental-psychotic and mania-fatigue sub-types were that the latter were significantly more likely to have a family history of bipolar disorder but have less likelihood of impaired verbal learning; whilst the anxious-depression group were more anxious, more likely to have a family history of depression, and had a higher premorbid IQ level. Conclusions This cross-sectional evaluation provides preliminary support for differing developmental trajectories in young persons presenting for mental health care. Prospective follow-up is needed to examine the predictive validity of this approach and its relationships to underlying pathophysiological mechanisms. PMID:24215120

  7. Velo-cardio-facial syndrome and psychotic disorders: Implications for psychiatric genetics

    SciTech Connect

    Chow, W.C.; Bassett, A.S.; Weksberg, R.

    1994-06-15

    Psychiatric disorders have been reported in over 10% of patients with velo-cardio-facial syndrome (VCFS) in long-term follow-up. To further explore the behavioral and psychiatric findings associated with VCFS in adulthood, detailed clinical histories of two patients - one with VCFS who developed a psychotic illness, and one with schizophrenia who was found to have dysmorphological features associated with VCFS - are described in the current report. The observed overlap of physical and psychiatric symptoms in these two patients suggests that VCFS and psychotic disorders may share a pathogenetic mechanism. This could be consistent with a contiguous gene model for VCFS and psychosis, suggesting chromosome 22q11 as a possible candidate region for genetic studies of schizophrenia. 26 refs., 2 tabs.

  8. Genome-wide association analysis of age at onset and psychotic symptoms in bipolar disorder

    PubMed Central

    Mahon, Pamela Belmonte; Pirooznia, Mehdi; Goes, Fernando S.; Seifuddin, Fayaz; Steele, Jo; Lee, Phil Hyoun; Huang, Jie; Hamshere, Marian; DePaulo, J. Raymond; Kelsoe, John R.; Rietschel, Marcella; Nöthen, Markus; Cichon, Sven; Gurling, Hugh; Purcell, Shaun; Smoller, Jordan W.; Craddock, Nick; Schulze, ThomasG.; McMahon, Francis J.; Potash, James B.; Zandi, Peter P.

    2011-01-01

    Genome-wide association studies (GWAS) have identified several susceptibility loci for bipolar disorder (BP), most notably ANK3. However, most of the inherited risk for BP remains unexplained. One reason for the limited success may be the genetic heterogeneity of BP. Clinical sub-phenotypes of BP may identify more etiologically homogeneous subsets of patients, which can be studied with increased power to detect genetic variation. Here, we report on a mega-analysis of two widely studied sub-phenotypes of BP, age at onset and psychotic symptoms, which are familial and clinically significant. We combined data from three GWAS: NIMH Bipolar Disorder Genetic Association Information Network (GAIN-BP), NIMH Bipolar Disorder Genome Study(BiGS), and a German sample. The combined sample consisted of 2836 BP cases with information on sub-phenotypes and 2744 controls. Imputation was performed, resulting in 2.3 million SNPs available for analysis. No SNP reached genome-wide significance for either sub-phenotype. In addition, no SNP reached genome-wide significance in a meta-analysis with an independent replication sample. We had 80% power to detect associations with a common SNP at an OR of 1.6 for psychotic symptoms and a mean difference of 1.8 years in age at onset. Age at onset and psychotic symptoms in BP may be influenced by many genes of smaller effect sizes or other variants not measured well by SNP arrays, such as rare alleles. PMID:21305692

  9. The fragmented self: imbalance between intrinsic and extrinsic self-networks in psychotic disorders.

    PubMed

    Ebisch, Sjoerd J H; Aleman, André

    2016-08-01

    Self-disturbances are among the core features of schizophrenia and related psychotic disorders. The basic structure of the self could depend on the balance between intrinsic and extrinsic self-processing. We discuss studies on self-related processing in psychotic disorders that provide converging evidence for disrupted communication between neural networks subserving the so-called intrinsic self and extrinsic self. This disruption might be mainly caused by impaired integrity of key brain hubs. The intrinsic self has been associated with cortical midline structures involved in self-referential processing, autobiographical memory, and emotional evaluation. Additionally, we highlight central aspects of the extrinsic self in its interaction with the environment using sensorimotor networks, including self-experience in sensation and actions. A deficient relationship between these self-aspects because of disrupted between-network interactions offers a framework to explain core clinical features of psychotic disorders. In particular, we show how relative isolation and reduced modularity of networks subserving intrinsic and extrinsic self-processing might trigger the emergence of hallucinations and delusions, and why patients with psychosis typically have difficulties with self-other relationships and do not recognise mental problems. PMID:27374147

  10. The Association of Salvia divinorum and Psychotic Disorders: A Review of the Literature and Case Series.

    PubMed

    El-Khoury, Joseph; Sahakian, Nayiri

    2015-01-01

    The association of substance abuse and psychotic disorders is of interest to clinicians, academics, and lawmakers. Commonly abused substances, such as cannabis, cocaine, amphetamines, and alcohol, have all been associated with substance-induced psychosis. Hallucinogens can induce desired psychedelic effects and undesirable psychomimetic reactions. These are usually transient and resolve once the duration of action is over. Sometimes, these effects persist, causing distress and requiring intervention. This article focuses on the hallucinogenic substance Salvia divinorum, the use of which has been observed, particularly among youth worldwide. We present background information based on a review of the literature and on our own clinical encounters, as highlighted by two original case reports. We hypothesize that consumption of Salvia divinorum could be associated with the development of psychotic disorders. We propose that clinicians routinely inquire about the use of Salvia in patients with substance use disorders or psychotic illnesses. More research is required to assess any relationship between Salvia divinorum and psychosis. Additionally, we advocate increased public and medical awareness of this substance and other emerging drugs of abuse. PMID:26317561

  11. [Neuropsychological syndromes of non-psychotic mental disorders of youthful age].

    PubMed

    Pluzhnikov, I V; Omelchenko, M A; Krylova, E S; Kaleda, V G

    2013-01-01

    Seventy male patients with non-psychotic mental disorders of youthful age (mean age 19.2±3.7), were studied using A.R. Luria neuropsychological syndrome analysis. Patients were stratified into 3 groups by diagnosis: cyclothymia (20 patients), pubertal decompensation of schizoid personality disorder (30 patients) and schizotypal personality disorder (20 patients). It has been shown that the neuropsychological changes indicate the dysfunction of the amygdale/temporal region in patients of the first group and frontal/thalamic/parietal connections in the patients of two other groups. There were interhemispheric differences between patients with personality disorder and schizotypal personality disorder: left hemisphere dysfunction was characteristic of schizotypal disorder and right hemisphere deficit (neurocognitive deficit) was found in patients with personality disorder. PMID:24430030

  12. Childhood trauma, midbrain activation and psychotic symptoms in borderline personality disorder

    PubMed Central

    Nicol, K; Pope, M; Romaniuk, L; Hall, J

    2015-01-01

    Childhood trauma is believed to contribute to the development of borderline personality disorder (BPD), however the mechanism by which childhood trauma increases risk for specific symptoms of the disorder is not well understood. Here, we explore the relationship between childhood trauma, brain activation in response to emotional stimuli and psychotic symptoms in BPD. Twenty individuals with a diagnosis of BPD and 16 healthy controls were recruited to undergo a functional MRI scan, during which they viewed images of faces expressing the emotion of fear. Participants also completed the childhood trauma questionnaire (CTQ) and a structured clinical interview. Between-group differences in brain activation to fearful faces were limited to decreased activation in the BPD group in the right cuneus. However, within the BPD group, there was a significant positive correlation between physical abuse scores on the CTQ and BOLD signal in the midbrain, pulvinar and medial frontal gyrus to fearful (versus neutral) faces. In addition there was a significant correlation between midbrain activation and reported psychotic symptoms in the BPD group (P<0.05). These results show that physical abuse in childhood is, in individuals with BPD, associated with significantly increased activation of a network of brain regions including the midbrain in response to emotional stimuli. Sustained differences in the response of the midbrain to emotional stimuli in individuals with BPD who suffered childhood physical abuse may underlie the vulnerability of these patients to developing psychotic symptoms. PMID:25942040

  13. Childhood trauma, midbrain activation and psychotic symptoms in borderline personality disorder.

    PubMed

    Nicol, K; Pope, M; Romaniuk, L; Hall, J

    2015-01-01

    Childhood trauma is believed to contribute to the development of borderline personality disorder (BPD), however the mechanism by which childhood trauma increases risk for specific symptoms of the disorder is not well understood. Here, we explore the relationship between childhood trauma, brain activation in response to emotional stimuli and psychotic symptoms in BPD. Twenty individuals with a diagnosis of BPD and 16 healthy controls were recruited to undergo a functional MRI scan, during which they viewed images of faces expressing the emotion of fear. Participants also completed the childhood trauma questionnaire (CTQ) and a structured clinical interview. Between-group differences in brain activation to fearful faces were limited to decreased activation in the BPD group in the right cuneus. However, within the BPD group, there was a significant positive correlation between physical abuse scores on the CTQ and BOLD signal in the midbrain, pulvinar and medial frontal gyrus to fearful (versus neutral) faces. In addition there was a significant correlation between midbrain activation and reported psychotic symptoms in the BPD group (P<0.05). These results show that physical abuse in childhood is, in individuals with BPD, associated with significantly increased activation of a network of brain regions including the midbrain in response to emotional stimuli. Sustained differences in the response of the midbrain to emotional stimuli in individuals with BPD who suffered childhood physical abuse may underlie the vulnerability of these patients to developing psychotic symptoms. PMID:25942040

  14. SCID-PANSS: two-tier diagnostic system for psychotic disorders.

    PubMed

    Kay, S R; Opler, L A; Spitzer, R L; Williams, J B; Fiszbein, A; Gorelick, A

    1991-01-01

    The SCID-PANSS was developed as a two-tier diagnostic system for psychotic disorders to supplement categorical diagnosis with functional-dimensional assessment. The procedure combines the DSM-III-R Structured Clinical Interview and Rating Criteria (SCID) with those from the Positive and Negative Syndrome Scale (PANSS). The comprehensive 50- to 60-minute interview yields diagnostic classification, plus a profile of 30 symptoms and 10 dimensional scales, including positive and negative syndromes, depression, thought disturbance, and severity of illness. A study of 34 psychotic inpatients assessed by five psychiatrists showed strong interrater correlations (0.85 to 0.97 for summary scales, P less than .0001), supporting the reliability of the SCID-PANSS for clinical and research applications. PMID:1935026

  15. PSYCHOTIC DISORDERS GENERATED BY AUTOIMMUNE ENCEPHALITIS (CLINICAL CASE).

    PubMed

    Craciun, Georgiana; Cucoş, Liliana; Ungureanu, Elena; Pendefunda, L; Petrariu, F D; Nechita, Petronela

    2015-01-01

    Encephalitis is a brain inflammation, which could involve also the meninges. The etiology of encephalitis could be: viral, bacterial, fungal or autoimmune. Anti-NMDAR encephalitis is an immune disorder, easy to diagnose and is a treatable condition. Most patients with anti-NMDAR encephalitis develop a multistage illness that progresses from psychosis, memory deficits, seizures, to catatonic state and breathing instability. We present a case report of a 20-year old woman, who presented: amnesia, visual hallucination, illusions, seizures after that occurred following autoimmune encephalitis. The exact incidence of anti-NMDAR encephalitis is unknown, but it seems to be more frequent than any other known paraneoplastic encephalitis. The present case is important considering that autoimmune encephalitis is a rare frequency disorder in Romania, with patients presenting resounding psychiatric and neurological manifestations. PMID:26793848

  16. Assessing and Treating the Patient with Acute Psychotic Disorders.

    PubMed

    Jensen, Lisa; Clough, Rebecca

    2016-06-01

    Patients with acute psychosis often present to emergency departments. Management of acute agitation and psychosis can be a challenge for the staff. Medical stabilization, appropriate assessment, and diagnosis are important. Verbal de-escalation and other psychosocial interventions are helpful in creating a safe and therapeutic environment. Psychiatric and emergency room nurses are poised to treat patients presenting with acute psychosis and must be knowledgeable of evidence-based approaches to treat these complex disorders. PMID:27229275

  17. [Interpersonal violence in the context of affective and psychotic disorders].

    PubMed

    Maier, W; Hauth, I; Berger, M; Saß, H

    2016-01-01

    Some mental and neurobiological disorders are associated with an increased risk for violence against others. The stigmatization of people with mental illnesses essentially emerges from a distorted perception of this condition. This review article summarizes the available literature on the determinants, prevention, therapy and tools for prediction of serious interpersonal aggression in the context of people with mental disorders. The risks for violence against other people show substantial variation between the various diagnoses. Schizophrenia and mania carry a clearly increased risk particularly at the onset of the disorder but disease-specific pharmacological therapy can reduce these risks. The highest risk factors are in particular previous violence, misuse of alcohol and drugs, male gender and young age. Probabilistic predictions of subsequent aggression against others on an individual-specific basis are only feasible in enriched populations (especially persons with mental illnesses and a previous history of assaults). Valid individual-specific predictions of future violence in the general population or on the basis of diagnoses of mental illness are, however, currently not feasible with sufficient accuracy. PMID:26676656

  18. Evidence for a Shared Etiological Mechanism of Psychotic Symptoms and Obsessive-Compulsive Symptoms in Patients with Psychotic Disorders and Their Siblings

    PubMed Central

    Roza, Sabine; Schoevers, Robert; Myin-Germeys, Inez; de Haan, Lieuwe

    2015-01-01

    The prevalence of obsessive-compulsive disorder in subjects with psychotic disorder is much higher than in the general population. The higher than chance co-occurrence has also been demonstrated at the level of subclinical expression of both phenotypes. Both extended phenotypes have been shown to cluster in families. However, little is known about the origins of their elevated co-occurrence. In the present study, evidence for a shared etiological mechanism was investigated in 3 samples with decreasing levels of familial psychosis liability: 987 patients, 973 of their unaffected siblings and 566 healthy controls. The association between the obsessive-compulsive phenotype and the psychosis phenotype c.q. psychosis liability was investigated. First, the association was assessed between (subclinical) obsessive-compulsive symptoms and psychosis liability. Second, in a cross-sib cross-trait analysis, it was examined whether (subclinical) obsessive-compulsive symptoms in the patient were associated with (subclinical) psychotic symptoms in the related unaffected sibling. Evidence was found for both associations, which is compatible with a partially shared etiological pathway underlying obsessive-compulsive and psychotic disorder. This is the first study that used a cross-sib cross-trait design in patients and unaffected siblings, thus circumventing confounding by disease-related factors present in clinical samples. PMID:26061170

  19. Impact of childhood adversities on the short-term course of illness in psychotic spectrum disorders.

    PubMed

    Schalinski, Inga; Fischer, Yolanda; Rockstroh, Brigitte

    2015-08-30

    Accumulating evidence indicates an impact of childhood adversities on the severity and course of mental disorders, whereas this impact on psychotic disorders remains to be specified. Effects of childhood adversities on comorbidity, on symptom severity of the Positive and Negative Syndrome Scale and global functioning across four months (upon admission, 1 and 4 months after initial assessment), as well as the course of illness (measured by the remission rate, number of re-hospitalizations and dropout rate) were evaluated in 62 inpatients with psychotic spectrum disorders. Adverse experiences (of at least 1 type) were reported by 73% of patients. Patients with higher overall level of childhood adversities (n=33) exhibited more co-morbid disorders, especially alcohol/substance abuse and dependency, and higher dropout rates than patients with a lower levels of adverse experiences (n=29), together with higher levels of positive symptoms and symptoms of excitement and disorganization. Emotional and physical neglect were particularly related to symptom severity. Results suggest that psychological stress in childhood affects the symptom severity and, additionally, a more unfavorable course of disorder in patients diagnosed with psychoses. This impact calls for its consideration in diagnostic assessment and psychiatric care. PMID:26099657

  20. Behavioural and molecular endophenotypes in psychotic disorders reveal heritable abnormalities in glutamatergic neurotransmission

    PubMed Central

    Scoriels, L; Salek, R M; Goodby, E; Grainger, D; Dean, A M; West, J A; Griffin, J L; Suckling, J; Nathan, P J; Lennox, B R; Murray, G K; Bullmore, E T; Jones, P B

    2015-01-01

    Psychotic disorders such as schizophrenia are biologically complex and carry huge population morbidity due to their prevalence, persistence and associated disability. Defined by features such as delusions and hallucinations, they involve cognitive dysfunction and neurotransmitter dysregulations that appear mostly to involve the dopaminergic and glutamatergic systems. A number of genetic and environmental factors are associated with these disorders but it has been difficult to identify the biological pathways underlying the principal symptoms. The endophenotype concept of stable, heritable traits that form a mechanistic link between genes and an overt expression of the disorder has potential to reduce the complexity of psychiatric phenotypes. In this study, we used a genetically sensitive design with individuals with a first episode of psychosis, their non-affected first-degree relatives and non-related healthy controls. Metabolomic analysis was combined with neurocognitive assessment to identify multilevel endophenotypic patterns: one concerned reaction times during the performance of cognitive and emotional tests that have previously been associated with the glutamate neurotransmission system, the other involved metabolites involved directly and indirectly in the co-activation of the N-methyl-D-aspartate receptor, a major receptor of the glutamate system. These cognitive and metabolic endophenotypes may comprise a single construct, such that genetically mediated dysfunction in the glutamate system may be responsible for delays in response to cognitive and emotional functions in psychotic disorders. This focus on glutamatergic neurotransmission should guide drug discovery and experimental medicine programmes in schizophrenia and related disorders. PMID:25826115

  1. A view from Riggs: treatment resistance and patient authority-IX. Integrative psychodynamic treatment of psychotic disorders.

    PubMed

    Tillman, Jane G

    2008-01-01

    Psychotic spectrum disorders present treatment challenges for patients, families, and clinicians. This article addresses the history of the dualism in the field between biological and psychological approaches to mental disorders, and surveys the contemporary literature about the etiology and treatment of psychotic spectrum disorders. An integrative approach to treatment derived from work at Austen Riggs with previously treatment refractory patients with psychotic spectrum disorders is described that combines individual psycho- dynamic psychotherapy, psychopharmacology, family systems approaches, and intensive psychosocial engagement. Helping patients develop their own authority to join the treatment, use relationships for learning, and understand the meaning of their symptoms is central to the treatment at Austen Riggs. An extended case vignette of a patient diagnosed with a schizoaffective disorder is presented illustrating this integrative psychodynamic treatment approach. PMID:19113964

  2. PhenoChipping of psychotic disorders: a novel approach for deconstructing and quantitating psychiatric phenotypes.

    PubMed

    Niculescu, Alexander B; Lulow, Len L; Ogden, Corey A; Le-Niculescu, Helen; Salomon, Daniel R; Schork, Nicholas J; Caligiuri, Michael P; Lohr, James B

    2006-09-01

    Psychiatric phenotypes as currently defined are primarily the result of clinical consensus criteria rather than empirical research. We propose, and present initial proof of principle for, a novel approach to characterizing psychiatric phenotypes. We have termed our approach PhenoChipping, by analogy with, and borrowing paradigms and tools from, gene expression microarray studies (GeneChipping). A massive parallel profiling of cognitive and affective state is done with a PhenoChip composed of a battery of existing and new quantitative psychiatric rating scales, as well as hand neuromotor measures. We present preliminary data from 104 subjects, 72 with psychotic disorders (bipolar disorder-41, schizophrenia-17, schizoaffective disorder-14), and 32 normal controls. Microarray data analysis software and visualization tools were used to investigate: 1. relationships between phenotypic items ("phenes"), including with objective motor measures, and 2. relationships between subjects. Our analyses revealed phenotypic overlap among, as well as phenotypic heterogeneity within, the three major psychotic disorders studied. This approach may be useful in helping us move beyond current diagnostic classifications, and suggests a combinatorial building-block (Lego-like) structure underlies psychiatric syndromes. The adaptation of microarray informatic tools for phenotypic analysis readily facilitates direct integration with gene expression profiling of lymphocytes in the same individuals, a strategy for molecular biomarker identification. Empirically derived clusterings of (endo)phenotypes and of patients will better serve genetic, pharmacological, and imaging research, as well as clinical practice. PMID:16838358

  3. Cerebellar Volume in Schizophrenia and Bipolar I Disorder with and without Psychotic Features

    PubMed Central

    Laidi, Charles; d’Albis, Marc-Antoine; Wessa, Michèle; Linke, Julia; Phillips, Mary; Delavest, Marine; Bellivier, Frank; Versace, Amelia; Almeida, Jorge; Sarrazin, Samuel; Poupon, Cyril; Le Dudal, Katia; Daban, Claire; Hamdani, Nora; Leboyer, Marion; Houenou, Josselin

    2014-01-01

    Objective There is growing evidence that cerebellum plays a crucial role in cognition and emotional regulation. Cerebellum is likely to be involved in the physiopathology of both bipolar disorder and schizophrenia. The objective of our study was to compare cerebellar size between patients with bipolar disorder patients with schizophrenia and healthy controls in a multicenter sample. In addition, we studied the influence of psychotic features on cerebellar size in bipolar patients. Method One hundred and fifteen bipolar I patients, thirty-two patients with schizophrenia and fifty-two healthy controls underwent 3 Tesla MRI. Automated segmentation of cerebellum was performed using FreeSurfer software. Volumes of cerebellar cortex and white matter were extracted. Analyses of covariance were conducted and age, sex and intracranial volume were considered as covariates. Results Bilateral cerebellar cortical volumes were smaller in patients with schizophrenia compared to patients with bipolar I disorder and healthy controls. We found no significant difference of cerebellar volume between bipolar patients with and without psychotic features. No change was evidenced in white matter. Conclusion Our results suggest that reduction of cerebellar cortical volume is specific to schizophrenia. Cerebellar dysfunction in bipolar disorder, if present, appears to be more subtle than a reduction in cerebellar volume. PMID:25430729

  4. Use of synthetic cannabinoids in patients with psychotic disorders: case series.

    PubMed

    Celofiga, Andreja; Koprivsek, Jure; Klavz, Janez

    2014-01-01

    An increasing number of synthetic cannabinoids have become available on the black market in recent years, and health professionals have seen a corresponding increase in use of these compounds among patients with psychiatric disorders. Unfortunately, there is almost no research available in the literature on this topic, and what little exists is based on case reports of individuals without psychiatric disorders. Synthetic cannabinoids are functionally similar to, but structurally different from, delta-9-tetrahydrocannabinol, the active principle in cannabis, and are problematic for many reasons. The psychotropic action of synthetic cannabinoids in patients with schizophrenia is unpredictable, with very diverse clinical presentations. These drugs can be much more potent than delta-9-tetrahydrocannabinol, they are readily available and difficult to detect. The gold standard for identification of synthetic cannabinoids is gas chromatography with mass spectrometry, but even this is difficult because new formulations of these designer drugs are constantly emerging. In this manuscript, we provide an overview and discussion of synthetic cannabinoids and present four cases of patients with synthetic cannabinoid intoxication who were hospitalized in our intensive psychiatric unit at the time of intoxication. All patients had a history of schizophrenia and had been hospitalized several times previously. While hospitalized, they smoked an unknown substance brought in by a visitor, which was then confirmed using gas chromatography with mass spectrometry to be the synthetic cannabinoid AM-2201. Our patients experienced predominantly psychiatric adverse clinical effects. We observed the appearance of new psychotic phenomena, without exacerbation of their previously known psychotic symptoms, as well as the occurrence or marked worsening of mood and anxiety symptoms. Despite several similar reactions, and even though they ingested the same exact substance, the clinical picture

  5. Mind-body medicine for schizophrenia and psychotic disorders: a review of the evidence.

    PubMed

    Helgason, Chanel; Sarris, Jerome

    2013-10-01

    Over half of psychiatric patients use some kind of Complementary and Alternative Medicine, with Mind-Body Medicine (MBM) being the most commonly used collective modality. To date however, to our knowledge, no overarching review exists examining MBM for psychotic disorders. Thus the purpose of this paper is to present the first review in this area. A MEDLINE search was conducted of articles written in English from 1946 up to January 15, 2011 using a range of MBM and psychotic disorder search terms. Human clinical trials and, where available, pertinent meta-analyses and reviews were included in this paper. Forty-two clinical studies and reviews of MBMs were located, revealing varying levels of evidence. All studies included used MBMs as an adjunctive therapy to usual care, including medication. Overall, supportive evidence was found for music therapy, meditation and mindfulness techniques. Some positive studies were found for yoga and breathing exercises, general relaxation training, and holistic multi-modality MBM interventions. Due to insufficient data, a conclusion cannot be reached for hypnosis, thermal or EMG biofeedback, dance or drama therapy, or art therapy. No clinical trials were found for guided imagery, autogenic training, journal writing, or ceremony practices. For many techniques, the quality of research was poor, with many studies having small samples, no randomization, and no adequate control. While the above techniques are likely to be safe and tolerable in this population based on current data, more research is required to decisively assess the validity of applying many MBMs in the mainstream treatment of psychotic disorders. PMID:23428783

  6. Interplay Between Childhood Physical Abuse and Familial Risk in the Onset of Psychotic Disorders

    PubMed Central

    Fisher, Helen L.; McGuffin, Peter; Boydell, Jane; Fearon, Paul; Craig, Thomas K.; Dazzan, Paola; Morgan, Kevin; Doody, Gillian A.; Jones, Peter B.; Leff, Julian; Murray, Robin M.; Morgan, Craig

    2014-01-01

    Background: Childhood abuse is considered one of the main environmental risk factors for the development of psychotic symptoms and disorders. However, this association could be due to genetic factors influencing exposure to such risky environments or increasing sensitivity to the detrimental impact of abuse. Therefore, using a large epidemiological case-control sample, we explored the interplay between a specific form of childhood abuse and family psychiatric history (a proxy for genetic risk) in the onset of psychosis. Methods: Data were available on 172 first presentation psychosis cases and 246 geographically matched controls from the Aetiology and Ethnicity of Schizophrenia and Other Psychoses study. Information on childhood abuse was obtained retrospectively using the Childhood Experience of Care and Abuse Questionnaire and occurrence of psychotic and affective disorders in first degree relatives with the Family Interview for Genetic Studies. Results: Parental psychosis was more common among psychosis cases than unaffected controls (adjusted OR = 5.96, 95% CI: 2.09–17.01, P = .001). Parental psychosis was also associated with physical abuse from mothers in both cases (OR = 3.64, 95% CI: 1.06–12.51, P = .040) and controls (OR = 10.93, 95% CI: 1.03–115.90, P = .047), indicative of a gene-environment correlation. Nevertheless, adjusting for parental psychosis did not measurably impact on the abuse-psychosis association (adjusted OR = 3.31, 95% CI: 1.22–8.95, P = .018). No interactions were found between familial liability and maternal physical abuse in determining psychosis caseness. Conclusions: This study found no evidence that familial risk accounts for associations between childhood physical abuse and psychotic disorder nor that it substantially increases the odds of psychosis among individuals reporting abuse. PMID:24399191

  7. A Comparative Study on Alexithymia in Depressive, Somatoform, Anxiety, and Psychotic Disorders among Koreans

    PubMed Central

    Son, Sung hwa; Jo, Hyunyoung; Rim, Hyo Deog; Kim, Ju Hee; Kim, Hea Won; Bae, Geum Ye

    2012-01-01

    Objective Little is known about the characteristic differences in alexithymic construct in various psychiatric disorders because of a paucity of direct comparisons between psychiatric disorders. Therefore, this study explored disorder-related differences in alexithymic characteristics among Korean patients diagnosed with four major psychiatric disorders (n=388). Methods Alexithymic tendencies, as measured by the Korean version of the 20-item Toronto Alexithymia Scale (TAS-20K), of patients classified into four groups according to major psychiatric diagnosis were compared. The groups consisted of patients with depressive disorders (DP; n=125), somatoform disorders (SM; n=78), anxiety disorders (AX; n=117), and psychotic disorders (PS; n=68). Results We found that substantial portions of patients in all groups were classified as having alexithymia and no statistical intergroup differences emerged (42.4%, 35.9%, 35.3%, and 33.3% for DP, SM, PS, and AX). However, patients with DP obtained higher scores in factor 2 (difficulties describing feelings) than those with SM or AX, after adjusting for demographic variables. Conclusion These findings suggest that alexithymia might be associated with a higher vulnerability to depressive disorders and factor 2 of TAS-20K could be a discriminating feature of depressive disorders. PMID:23251195

  8. The role of social media networks in psychotic disorders: a case report.

    PubMed

    Krishna, Nithin; Fischer, Bernard A; Miller, Moshe; Register-Brown, Kelly; Patchan, Kathleen; Hackman, Ann

    2013-01-01

    We report the case of a young man diagnosed with schizophrenia who presented with stalking behaviors that may have been caused by problematic use or participation in social media networks (SMN). We review the possible role of SMN in the formation of his romantic delusion and offer suggestions for clinicians around incorporation of SMN questions into assessments. It is imperative to identify populations at risk of SMN-related stalking behaviors to stratify mental health resources and interventions. Additional studies are needed to further clarify the role of SMN in psychotic disorders. PMID:23174460

  9. Early signs, diagnosis and therapeutics of the prodromal phase of schizophrenia and related psychotic disorders

    PubMed Central

    Larson, Molly K; Walker, Elaine F; Compton, Michael T

    2010-01-01

    During recent decades, interest in the prevention of mental illnesses has increased. Improved diagnostic tools, the advent of atypical antipsychotic medications and the development of phase-specific psychosocial treatments have made intervention research in people at ultra-high risk for developing schizophrenia or a related psychotic disorder possible. Preliminary data suggest that low doses of atypical antipsychotic medications augmented by psychosocial treatments may delay the onset of psychosis in some individuals. Findings support further research for the establishment of best-practice standards. PMID:20662758

  10. Psychotic-like experiences and disordered eating in the English general population.

    PubMed

    Koyanagi, Ai; Stickley, Andrew; Haro, Josep Maria

    2016-07-30

    There are no studies on psychotic-like experiences (PLEs) and disordered eating in the general population. We aimed to assess this association in the English adult population. Data from the 2007 Adult Psychiatric Morbidity Survey (APMS) were analyzed. This was a nationally representative survey comprising 7403 English adults aged ≥16 years. The Psychosis Screening Questionnaire was used to identify the past 12-month occurrence of five forms of psychotic symptoms. Questions from the five-item SCOFF screening instrument were used to identify those with eating disorder (ED) symptoms and possible ED in the past year. The prevalence of any PLE was 5.1% (female) and 5.4% (male), while that of possible ED was 9.0% (female) and 3.5% (male). After adjustment for potential confounders, possible ED was associated with hypomania/mania in females (OR=3.23 95%CI=1.002-10.39), strange experiences [females (OR=1.85 95%CI=1.07-3.20) and males (OR=3.54 95%CI=1.65-7.57)], and any PLE in males (OR=3.44 95%CI=1.85-6.39). An interaction analysis revealed that the association was stronger among males for: auditory hallucinations and uncontrolled eating; and any PLE with uncontrolled eating, food dominance, and possible ED. Clinical practitioners should be aware that PLEs and disordered eating behavior often coexist. When one condition is detected, screening for the other may be advisable, especially among males. PMID:27152907

  11. A Network Approach to Environmental Impact in Psychotic Disorder: Brief Theoretical Framework.

    PubMed

    Isvoranu, Adela-Maria; Borsboom, Denny; van Os, Jim; Guloksuz, Sinan

    2016-07-01

    The spectrum of psychotic disorder represents a multifactorial and heterogeneous condition and is thought to result from a complex interplay between genetic and environmental factors. In the current paper, we analyze this interplay using network analysis, which has been recently proposed as a novel psychometric framework for the study of mental disorders. Using general population data, we construct network models for the relation between 3 environmental risk factors (cannabis use, developmental trauma, and urban environment), dimensional measures of psychopathology (anxiety, depression, interpersonal sensitivity, obsessive-compulsive disorder, phobic anxiety, somatizations, and hostility), and a composite measure of psychosis expression. Results indicate the existence of specific paths between environmental factors and symptoms. These paths most often involve cannabis use. In addition, the analyses suggest that symptom networks are more strongly connected for people exposed to environmental risk factors, implying that environmental exposure may lead to less resilient symptom networks. PMID:27179124

  12. Frequency of Latent and Smear Positive Tuberculosis in Chronic Psychotic Disorders

    PubMed Central

    Ebrahimi, Hannan; Mohammadi, Alieh; Jahromi, Sina Khajeh; Naghdipour, Misa; Ebrahimi, Hossein

    2013-01-01

    Objective Screening is one of the ways to combat Tuberculosis (TB) and should be mostly concentrated on groups showing some symptoms of the disease. Tuberculosis can be transferred from person to person in laboratories, prisons and psychiatry hospitals. The purpose of this study was to survey pulmonary TB in patients with schizophrenia in Rasht. Methods In this descriptive-cross sectional, Two hundred fifty seven consecutive patients with chronic psychotic disorder hospitalized in psychotic hospitals underwent purified protein derivative (PPD) test. PPD test was done with the unit 5T which was injected subcutaneously on anterior surface and at the top of left forearm. The results of the test were interpreted by the pen technique method and based on transverse diameter of induration of about 48-72 hrs. Induration size due to hypersensitivity to PPD more than 10mm was considered positive. Patients with positive PPD test underwent complementary sputum smear. Data were analyzed using chi- square and T test. Results The mean age of patients was 45±10 years; 75.5% were male, 74.7% were single, 10.5% married, 7.8% divorced, and 68.1% were smokers. These patients suffered from chronic psychotic disorder at the mean time of 15±7.9 years. In 74 patients (28%) positive PPD test were recorded, but active pulmonary TB was not found in complementary experiments of PPD sample. Based on data analysis, only age and gender showed a significant relationship with the results of the PPD test (P < 0.05). Conclusions This study showed that patients with positive PPD test are much more than the normal population, but active pulmonary TB was not observed in our samples. Since these patients are in clinical and closed places, more programs for screening are required. PMID:23682252

  13. Psychotic Disorders

    MedlinePlus

    ... Two of the main symptoms are delusions and hallucinations. Delusions are false beliefs, such as thinking that ... that the TV is sending you secret messages. Hallucinations are false perceptions, such as hearing, seeing, or ...

  14. Determinants of subjective and objective burden of informal caregiving of patients with psychotic disorders

    PubMed Central

    Flyckt, Lena; Fatouros-Bergman, Helena; Koernig, Thomas

    2015-01-01

    Background: In a previous study, the objective burden of informal caregiving to patients with psychotic disorders amounted to 22 hours/week, and the subjective burden was huge with predominately anxiety and depression as main symptoms. In this study, determinants of the informal caregiving burden are analyzed to find foci for interventions to ease the size of burden. Methods: Patients with psychotic disorders (n = 107) and their informal caregivers (n = 118) were included. They were assessed with a comprehensive battery of rating scales including patient and caregiver characteristics as well as the amount and quality of health-care provision. Results: A multiple linear regression analysis showed that the subjective burden was significantly lower when patients had higher levels of functioning and when the health status of the informal caregivers was good. No significant determinants were found for the objective burden, but an association was found between a higher socioeconomic status of the caregivers and the amount of money provided for the patient. An association was also found between a positive perception of caregiving and more hours spent on caregiving. Conclusion: The functioning level of the patients was the main determinant of the subjective burden of informal care. For the objective burden, no main determinant was found. PMID:25770207

  15. Effect of video self-observations vs. observations of others on insight in psychotic disorders.

    PubMed

    David, Anthony S; Chis Ster, Irina; Zavarei, Hooman

    2012-04-01

    Improving insight in patients with schizophrenia and related disorders is a worthwhile goal. Previous work has suggested that patients' insight may improve if they see videos of themselves taken when ill. Our aim was to test the hypothesis that schizophrenia patients improve their insight after viewing videos of themselves when unwell more so than after viewing an actor. Forty patients admitted with an acute psychotic disorder underwent a videotaped recording of a clinical interview. The patients were then randomized to viewing this or a "control" video of a same-sex actor displaying psychotic symptoms approximately 3 weeks later. Insight, psychopathology, and mood were assessed before and 24 to 48 hours after viewing the videos. All participants showed general improvement across all measures. There was a trend for scores on the Schedule for the Assessment of Insight to improve more in those who viewed themselves when ill, but there were no clear statistically significant differences between the "self" and "other" video groups. In conclusion, video self-confrontation seems to be a safe and potentially effective means of enhancing insight, but evidence for a specific effect is lacking. PMID:22456591

  16. Treatment of psychotic symptoms in bipolar disorder with aripiprazole monotherapy: a meta-analysis

    PubMed Central

    2009-01-01

    Background We present a systematic review and meta-analysis of the available clinical trials concerning the usefulness of aripiprazole in the treatment of the psychotic symptoms in bipolar disorder. Methods A systematic MEDLINE and repository search concerning clinical trials for aripiprazole in bipolar disorder was conducted. Results The meta-analysis of four randomised controlled trials (RCTs) on acute mania suggests that the effect size of aripiprazole versus placebo was equal to 0.14 but a more reliable and accurate estimation is 0.18 for the total Positive and Negative Syndrome Scale (PANSS) score. The effect was higher for the PANSS-positive subscale (0.28), PANSS-hostility subscale (0.24) and PANSS-cognitive subscale (0.20), and lower for the PANSS-negative subscale (0.12). No data on the depressive phase of bipolar illness exist, while there are some data in favour of aripiprazole concerning the maintenance phase, where at week 26 all except the total PANSS score showed a significant superiority of aripiprazole over placebo (d = 0.28 for positive, d = 0.38 for the cognitive and d = 0.71 for the hostility subscales) and at week 100 the results were similar (d = 0.42, 0.63 and 0.48, respectively). Conclusion The data analysed for the current study support the usefulness of aripiprazole against psychotic symptoms during the acute manic and maintenance phases of bipolar illness. PMID:20043829

  17. HPA-Axis Hyperactivity and Mortality in Psychotic Depressive Disorder: Preliminary Findings

    PubMed Central

    Coryell, William; Fiedorowicz, Jess; Zimmerman, Mark; Young, Elizabeth

    2008-01-01

    Background The excess mortality associated with depressive disorders has been most often attributed to risks for suicide but diverse findings indicate that depressive disorders also increase risks for cardiovascular (CV) mortality. Among the possible mediators is the HPA-axis hyperactivity that characterizes many cases of relatively severe depressive disorder and severity is characteristic of psychotic depressive disorder. Methods The following describes a 17-year mortality follow-up of 54 patients with Research Diagnostic Criteria (RDC) psychotic major depression or schizoaffective, mainly affective, depression. All had baseline assessments that included a 1mg dexamethasone suppression test with post-dexamethasone samples at 8 a.m., 4 p.m. and 11 p.m. Results Regression analyses showed that both greater age and higher maximum post-dexamethasone cortisol concentrations predicted deaths due to cardiovascular (CV) causes (t = 4.01, p < .001 and t = 3.03, p = .004, respectively); the 11 p.m. cortisol concentration predicted death due to suicide (t = 2.05, p = 0.048). The 4 who died from CV disease had a mean (SD) post-dexamethasone cortisol concentration of 18.0 (6.0) μg/dl while the mean (SD) value for the remaining 50 patients was 7.6 (6.6) μg/dl (t = 3.03, df = 53, p = 0.004). Regression analyses showed the 11 p.m. post-dexamethasone value to be predictive of suicide (t = 2.05, p = 0.048). Conclusions Conclusions should be tentative because an earlier follow-up of a more heterogeneous, but larger, sample did not find a relationship between DST results and CV mortality, and because only 4 CV deaths occurred in the present study. HPA-axis hyperactivity is probably only one of a number of factors that link depressive disorder to CV mortality. PMID:18378097

  18. Expert Canadian consensus suggestions on the rational, clinical use of ziprasidone in the treatment of schizophrenia and related psychotic disorders

    PubMed Central

    Kutcher, Stan; Brooks, Sarah J; Gardner, David M; Honer, Bill; Kopala, Lili; Labelle, Alain; Lalonde, Pierre; Malla, Ashok; Milliken, Heather; Soni, Jorge; Williams, Richard

    2005-01-01

    Many atypical antipsychotic medications are becoming available for clinical use. Ziprasidone is a recent addition to this group and is expected to become available for clinical use in Canada in 2005. Ziprasidone has some significant differences compared with other atypicals currently available in Canada. Clinicians need to understand the benefits and risks associated with each of the antipsychotic medications available for the treatment of schizophrenia and related psychotic disorders to ensure their most appropriate utilization. At the suggestion of Professor Stan Kutcher (chair) and as part of an ongoing commitment to provide independent education pertaining to the utility of new psychotropic compounds to health professionals, a panel of Canadian experts in the treatment of schizophrenia spectrum disorders was convened to provide consensus suggestions for the appropriate clinical use of ziprasidone. The consultations regarding the development of these recommendations were organized by Brainworks International (BWI) with arms-length funding from Pfizer Canada. This paper describes the experts’ consensus views on the efficacy and safety of ziprasidone, their suggestions on which patients may be suitable for ziprasidone treatment, and how to initiate treatment (including how to switch from other antipsychotic medications), manage side effects, and monitor patients in long-term therapy. These suggestions are those of the authors only and are not endorsed by or necessarily reflect the opinions of BWI or Pfizer Canada. PMID:18568067

  19. Association study of GABA system genes polymorphisms with amphetamine-induced psychotic disorder in a Han Chinese population.

    PubMed

    Zhang, Kai; Zhao, Yan; Wang, Qingzhong; Jiang, Haifeng; Du, Jiang; Yu, Shunying; Zhao, Min

    2016-05-27

    GABA system genes have been implicated in neurotrophy and neurogenesis, which play pivotal roles in an individual's variation in vulnerability to amphetamine addiction or amphetamine-induced psychosis (AIP). We hypothesized that common genetic variants in the GABA system genes may be associated with amphetamine-induced psychotic disorder. In our study, thirty-six single nucleotide polymorphisms (SNPs) within the GABA system genes were genotyped in 400 amphetamine-induced psychotic disorder patients and 400 amphetamine use disorders patients (AUP) (not including those categorized as psychosis) in the Han Chinese population. In this study, 51.88% of the Han Chinese amphetamine-type substance use disorder patients met the criteria of amphetamine-induced psychotic disorder, and 79.5% amphetamine-induced psychotic disorder patients had auditory hallucinations, while 46.5% had delusions of reference. The allele frequency of rs1129647 showed nominal association with AIP in the Han Chinese population (P=0.03). Compared with AUP group patients, T allele frequency of AIP group patients was significantly increased. The adjustment for age and gender factors in the AIP and AUP patients was executed using unconditional logistic regression under five inheritance models. The genotype frequency of rs1129647 showed nominal association with AIP in the log-additive model (P=0.04). The genotype frequency of rs2290733 showed nominal association with AIP in the recessive model (P=0.04). Compared with female AIP patients, male patients were more likely to have the CC genotype of rs17545383 (P=0.04). Moreover, we determined that more male patients carried the T allele of rs2290733 in the AIP group (P=0.004). Unfortunately, the significant differences did not survive Benjamini-Hochberg false discovery rate correction (adjusted P>0.05). No association between the SNPs of the GABA system genes and amphetamine-induced psychotic disorder risk was identified. No haplotype of the GABA system

  20. Sensation/novelty seeking in psychotic disorders: A review of the literature

    PubMed Central

    Peritogiannis, Vaios

    2015-01-01

    The evaluation of personality traits is important for the better understanding of the person suffering from psychosis and for treatment individualization. However literature on patients’ personality and character in such disorders is limited. The aim of this review was to summarize the literature on sensation/novelty seeking (SNS), a trait which is biologically based and highly heritable and is associated with dopamine activity, and refers to a person’s tendency to seek varied, novel, complex, and intense sensations and experiences. A total of 38 studies were included in this review, involving 2808 patients and 2039 healthy controls. There is consistent evidence that this trait is independently associated with alcohol and substance abuse in patients with schizophrenia and related disorders. The estimation of SNS would help clinicians to identify patients at risk for abuse. There is also some evidence that higher SNS levels may relate to medication non-adherence and seem to increase the risk of patients’ aggressive and violent behavior, but studies are scarce. SNS was found not to be related to suicidality, whereas in the fields of patients’ quality of life and psychopathology results are contradictory, but most studies show no possible association. Several studies suggest that SNS is lower in psychotic patients compared to controls, whereas most yield no differences. The evidence for this trait as a potential endophenotype of schizophrenia is weak. SNS may be implicated in psychotic disorders’ course and prognosis in several ways and should be always inquired for. This trait can be reliably measured with the use of easily applicable self-rated instruments, and patients’ accounts could inform clinicians when planning management and delivering individualized treatment. PMID:25815257

  1. Cognitive correlates of frontoparietal network connectivity 'at rest' in individuals with differential risk for psychotic disorder.

    PubMed

    Peeters, S C T; van Bronswijk, S; van de Ven, V; Gronenschild, E H B M; Goebel, R; van Os, J; Marcelis, M

    2015-11-01

    Altered frontoparietal network functional connectivity (FPN-fc) has been associated with neurocognitive dysfunction in individuals with (risk for) psychotic disorder. Cannabis use is associated with cognitive and FPN-fc alterations in healthy individuals, but it is not known whether cannabis exposure moderates the FPN-fc-cognition association. We studied FPN-fc in relation to psychosis risk, as well as the moderating effects of psychosis risk and cannabis use on the association between FPN-fc and (social) cognition. This was done by collecting resting-state fMRI scans and (social) cognitive test results from 63 patients with psychotic disorder, 73 unaffected siblings and 59 controls. Dorsolateral prefrontal cortex (DLPFC) seed-based correlation analyses were used to estimate FPN-fc group differences. Additionally, group×FPN-fc and cannabis×FPN-fc interactions in models of cognition were assessed with regression models. Results showed that DLPFC-fc with the left precuneus, right inferior parietal lobule, right middle temporal gyrus (MTG), inferior frontal gyrus (IFG) regions and right insula was decreased in patients compared to controls. Siblings had reduced DLPFC-fc with the right MTG, left middle frontal gyrus, right superior frontal gyrus, IFG regions, and right insula compared to controls, with an intermediate position between patients and controls for DLPFC-IFG/MTG and insula-fc. There were no significant FPN-fc×group or FPN-fc×cannabis interactions in models of cognition. Reduced DLPFC-insula-fc was associated with worse social cognition in the total sample. In conclusion, besides patient- and sibling-specific FPN-fc alterations, there was evidence for trait-related alterations. FPN-fc-cognition associations were not conditional on familial liability or cannabis use. Lower FPN-fc was associated with lower emotion processing in the total group. PMID:26411531

  2. Hospitalization rates in patients switched from oral anti-psychotics to aripiprazole once-monthly: final efficacy analysis

    PubMed Central

    Kane, John M.; Zhao, Cathy; Johnson, Brian R.; Baker, Ross A.; Eramo, Anna; McQuade, Robert D.; Duca, Anna R.; Sanchez, Raymond; Peters-Strickland, Timothy

    2015-01-01

    Abstract Objective: To compare hospitalization rates in patients with schizophrenia treated prospectively with aripiprazole once-monthly 400 mg (AOM 400; an extended-release injectable suspension) vs the same patients’ retrospective rates with their prior oral anti-psychotic therapy. Research design and methods: Multi-center, open-label, mirror-image, naturalistic study in a community setting in North America. Patients who required a change in treatment and/or would benefit from long-acting injectable anti-psychotic therapy were treated prospectively for 6 months with AOM 400. Retrospective data on hospitalization rates were obtained. Clinical trial registration: ClinicalTrials.gov: NCT01432444. Main outcome measures: The proportion of patients with ≥1 psychiatric inpatient hospitalization with oral anti-psychotic therapy examined retrospectively (months –4 to –1 before oral conversion) and after switching to AOM 400 (months 4–6 after initiating AOM 400). Results: Psychiatric hospitalization rates were significantly lower when patients were treated with AOM 400 compared with oral anti-psychotic therapy both in the 3-month primary efficacy sample (2.7% [n = 9/336] vs 27.1% [n = 91/336], respectively; p < 0.0001) and in the total sample (6-month prospective rate: 8.8% [n = 38/433] vs 6-month retrospective rate: 38.1% [n = 165/433]; p < 0.0001). Discontinuations due to adverse events (AEs) during cross-titration were lower in patients cross-titrated on oral aripiprazole for >1 and <4 weeks (2.9% [n = 7/239]) compared with patients cross-titrated for ≤1 week (10.4% [n = 5/48]). The most common treatment-emergent AEs during the prospective treatment phase were insomnia (6.7% [n = 29/431]) and akathisia (6.5% [n = 28/431]). Patient-rated injection-site pain decreased from the first injection to the last visit. Conclusions: In a community setting, patients with schizophrenia demonstrated significantly lower psychiatric

  3. Diagnostic Stability of Acute and Transient Psychotic Disorders in Developing Country Settings: An Overview

    PubMed Central

    Mehta, Shubham

    2015-01-01

    Acute and transient psychotic disorders (ATPD), introduced in the International Classification of Diseases (ICD-10) diagnostic system in 1992, are not receiving much attention in developing countries. Therefore, the main objective of this article is to review the literature related to the diagnostic stability of ATPD in developing countries. A PubMed search was conducted to review the studies concerned with this issue in the context of developing countries, as diagnostic stability is more of a direct test of validity of psychiatric diagnoses. Four publications were found. According to the literature search, the stability percentage of the ICD-10 ATPD diagnosis is 63-100%. The diagnostic shift is more commonly either towards bipolar disorder or schizophrenia, if any. Shorter duration of illness (<1 month) and abrupt onset (<48 hours) predict a stable diagnosis of ATPD. Based on available evidence, the diagnosis of ATPD appears to be relatively stable in developing countries. However, it is difficult to make a definitive conclusion, as there is a substantial lack of literature in developing country settings. PMID:26266021

  4. Diagnostic Stability of Acute and Transient Psychotic Disorders in Developing Country Settings: An Overview.

    PubMed

    Mehta, Shubham

    2015-02-24

    Acute and transient psychotic disorders (ATPD), introduced in the International Classification of Diseases (ICD-10) diagnostic system in 1992, are not receiving much attention in developing countries. Therefore, the main objective of this article is to review the literature related to the diagnostic stability of ATPD in developing countries. A PubMed search was conducted to review the studies concerned with this issue in the context of developing countries, as diagnostic stability is more of a direct test of validity of psychiatric diagnoses. Four publications were found. According to the literature search, the stability percentage of the ICD-10 ATPD diagnosis is 63-100%. The diagnostic shift is more commonly either towards bipolar disorder or schizophrenia, if any. Shorter duration of illness (<1 month) and abrupt onset (<48 hours) predict a stable diagnosis of ATPD. Based on available evidence, the diagnosis of ATPD appears to be relatively stable in developing countries. However, it is difficult to make a definitive conclusion, as there is a substantial lack of literature in developing country settings. PMID:26266021

  5. Psychotic Disorders and Repeat Offending: Systematic Review and Meta-analysis

    PubMed Central

    Fazel, Seena

    2011-01-01

    Objective: To undertake a systematic review and meta-analysis on the risk of repeat offending in individuals with psychosis and to assess the effect of potential moderating characteristics on risk estimates. Methods: A systematic search was conducted in 6 bibliographic databases from January 1966 to January 2009, supplemented with correspondence with authors. Studies that reported risks of repeat offending in individuals with psychotic disorders (n = 3511) compared with individuals with other psychiatric disorders (n = 5446) and healthy individuals (n = 71 552) were included. Risks of repeat offending were calculated using fixed- and random-effects models to calculate pooled odds ratios (ORs). Subgroup and meta-regression analyses were conducted to examine how risk estimates were affected by various study characteristics including mean sample age, study location, sample size, study period, outcome measure, duration of follow-up, and diagnostic criteria. Results: Twenty-seven studies, which included 3511 individuals with psychosis, were identified. Compared with individuals without any psychiatric disorders, there was a significantly increased risk of repeat offending in individuals with psychosis (pooled OR = 1.6, 95% confidence interval [CI] = 1.4–1.8), although this was only based on 4 studies. In contrast, there was no association when individuals with other psychiatric disorders were used as the comparison group (pooled OR = 1.0, 95% CI = 0.7–1.3), although there was substantial heterogeneity. Higher risk estimates were found in female-only samples with psychosis and in studies conducted in the United States. Conclusions: The association between psychosis and repeat offending differed depending on the comparison group. Despite this, we found no support for the findings of previous reviews that psychosis is associated with a lower risk of repeat offending. PMID:19959703

  6. Environmental factors during adolescence associated with later development of psychotic disorders - a nested case-control study.

    PubMed

    Bratlien, Unni; Øie, Merete; Haug, Elisabeth; Møller, Paul; Andreassen, Ole A; Lien, Lars; Melle, Ingrid

    2014-03-30

    Etiologies of psychotic disorders (schizophrenia and bipolar disorder) are conceptualized as interplay between genetic and environmental factors. The adolescent period is characterized by changes in social roles and expectations that may interact with biological changes or psychosocial stressors. Few studies focus on the adolescents' own reports of perceived risk factors. To assess differences at age 16 between persons who later develop psychotic disorders ("Confirmed Psychosis", CP) and their class-mates ("Population Controls", PC) we collected information on: (1) Social support factors (size of social network and expectancies of social support from friends), (2) Cognitive functioning (concentrating in the classroom, actual grades and expectancies of own academic achievements) and (3) Problems and stressors in families (illness or loss of work for parents), and in relationship with others (exposure to bullying, violence or sexual violation). Self-reported data from students at 15-16 years of age were linked to the case-registers from the "Thematically Organized Psychosis (TOP) Study". The CP group reported more economic problems in their families, smaller social network and lower academic expectation than the PC group. The results support the notion that long-term socioeconomic stressors in adolescence may serve as risk factors for the development of psychotic disorders. PMID:24495574

  7. Psychotic Depression, Posttraumatic Stress Disorder, and Engagement in Cognitive-Behavioral Therapy within an Outpatient Sample of Adults with Serious Mental Illness

    PubMed Central

    Gottlieb, Jennifer D.; Mueser, Kim T.; Rosenberg, Stanley D.; Xie, Haiyi; Wolfe, Rosemarie S.

    2010-01-01

    Depression with psychotic features afflicts a substantial number of people, and has been characterized by significantly greater impairment, higher levels of dysfunctional beliefs, and poorer response to psychopharmacological and psychosocial interventions than non-psychotic depression. Those with psychotic depression also experience a host of co-occurring disorders, including post-traumatic stress disorder (PTSD), which is not surprising, given the established relationships between trauma exposure and increased rates of psychosis, and between PTSD and major depression. To date, there has been very limited research on the psychosocial treatment of psychotic depression, and even less is known about those who also suffer from PTSD. The purpose of this study was to better understand the rates and clinical correlates of psychotic depression in those with PTSD. Clinical and symptom characteristics of 20 individuals with psychotic depression and 46 with non-psychotic depression, all with PTSD, were compared prior to receiving CBT for PTSD treatment or TAU. Patients with psychotic depression exhibited significantly higher levels of depression and anxiety, a weaker perceived therapeutic alliance with their case managers, more exposure to traumatic events and more negative beliefs related to their traumatic experiences, as well as increased levels of maladaptive cognitions about themselves and the world, compared to participants without psychosis. Implications for CBT treatment aimed at dysfunctional thinking for this population are discussed. PMID:21220064

  8. Metabolome in schizophrenia and other psychotic disorders: a general population-based study

    PubMed Central

    2011-01-01

    Background Persons with schizophrenia and other psychotic disorders have a high prevalence of obesity, impaired glucose tolerance, and lipid abnormalities, particularly hypertriglyceridemia and low high-density lipoprotein. More detailed molecular information on the metabolic abnormalities may reveal clues about the pathophysiology of these changes, as well as about disease specificity. Methods We applied comprehensive metabolomics in serum samples from a general population-based study in Finland. The study included all persons with DSM-IV primary psychotic disorder (schizophrenia, n = 45; other non-affective psychosis (ONAP), n = 57; affective psychosis, n = 37) and controls matched by age, sex, and region of residence. Two analytical platforms for metabolomics were applied to all serum samples: a global lipidomics platform based on ultra-performance liquid chromatography coupled to mass spectrometry, which covers molecular lipids such as phospholipids and neutral lipids; and a platform for small polar metabolites based on two-dimensional gas chromatography coupled to time-of-flight mass spectrometry (GC × GC-TOFMS). Results Compared with their matched controls, persons with schizophrenia had significantly higher metabolite levels in six lipid clusters containing mainly saturated triglycerides, and in two small-molecule clusters containing, among other metabolites, (1) branched chain amino acids, phenylalanine and tyrosine, and (2) proline, glutamic, lactic and pyruvic acids. Among these, serum glutamic acid was elevated in all psychoses (P = 0.0020) compared to controls, while proline upregulation (P = 0.000023) was specific to schizophrenia. After adjusting for medication and metabolic comorbidity in linear mixed models, schizophrenia remained independently associated with higher levels in seven of these eight clusters (P < 0.05 in each cluster). The metabolic abnormalities were less pronounced in persons with ONAP or affective psychosis. Conclusions Our

  9. Completion of Chronic Hepatitis C Virus Treatment in Interferon-Induced Major Depressive Disorder with Psychotic Features

    PubMed Central

    2011-01-01

    Interferon (IFN)-associated psychiatric disorders can be managed without interruption to hepatitis C virus (HCV) treatment. The limited number of cases in the literature reporting psychotic depression as an adverse drug reaction to IFN resulted in discontinuation of HCV therapy. The author reports a case of a 49 year-old man with chronic HCV genotype 1a treated with pegylated interferon-alpha and ribavirin developing major depressive disorder with psychotic features. The patient was successfully treated with both an antidepressant and antipsychotic for this suspected IFN-associated adverse drug effect while continuing 12 months of uninterrupted HCV treatment and subsequently achieving sustained hepatitis C virological response. Although IFN can cause distressing psychiatric disturbances, appropriate treatment with psychotropic agents and careful monitoring allows patients to be maintained on a full course of HCV treatment. PMID:22216051

  10. Multivariate genetic determinants of EEG oscillations in schizophrenia and psychotic bipolar disorder from the BSNIP study.

    PubMed

    Narayanan, B; Soh, P; Calhoun, V D; Ruaño, G; Kocherla, M; Windemuth, A; Clementz, B A; Tamminga, C A; Sweeney, J A; Keshavan, M S; Pearlson, G D

    2015-01-01

    Schizophrenia (SZ) and psychotic bipolar disorder (PBP) are disabling psychiatric illnesses with complex and unclear etiologies. Electroencephalogram (EEG) oscillatory abnormalities in SZ and PBP probands are heritable and expressed in their relatives, but the neurobiology and genetic factors mediating these abnormalities in the psychosis dimension of either disorder are less explored. We examined the polygenic architecture of eyes-open resting state EEG frequency activity (intrinsic frequency) from 64 channels in 105 SZ, 145 PBP probands and 56 healthy controls (HCs) from the multisite BSNIP (Bipolar-Schizophrenia Network on Intermediate Phenotypes) study. One million single-nucleotide polymorphisms (SNPs) were derived from DNA. We assessed eight data-driven EEG frequency activity derived from group-independent component analysis (ICA) in conjunction with a reduced subset of 10,422 SNPs through novel multivariate association using parallel ICA (para-ICA). Genes contributing to the association were examined collectively using pathway analysis tools. Para-ICA extracted five frequency and nine SNP components, of which theta and delta activities were significantly correlated with two different gene components, comprising genes participating extensively in brain development, neurogenesis and synaptogenesis. Delta and theta abnormality was present in both SZ and PBP, while theta differed between the two disorders. Theta abnormalities were also mediated by gene clusters involved in glutamic acid pathways, cadherin and synaptic contact-based cell adhesion processes. Our data suggest plausible multifactorial genetic networks, including novel and several previously identified (DISC1) candidate risk genes, mediating low frequency delta and theta abnormalities in psychoses. The gene clusters were enriched for biological properties affecting neural circuitry and involved in brain function and/or development. PMID:26101851

  11. Multivariate genetic determinants of EEG oscillations in schizophrenia and psychotic bipolar disorder from the BSNIP study

    PubMed Central

    Narayanan, B; Soh, P; Calhoun, V D; Ruaño, G; Kocherla, M; Windemuth, A; Clementz, B A; Tamminga, C A; Sweeney, J A; Keshavan, M S; Pearlson, G D

    2015-01-01

    Schizophrenia (SZ) and psychotic bipolar disorder (PBP) are disabling psychiatric illnesses with complex and unclear etiologies. Electroencephalogram (EEG) oscillatory abnormalities in SZ and PBP probands are heritable and expressed in their relatives, but the neurobiology and genetic factors mediating these abnormalities in the psychosis dimension of either disorder are less explored. We examined the polygenic architecture of eyes-open resting state EEG frequency activity (intrinsic frequency) from 64 channels in 105 SZ, 145 PBP probands and 56 healthy controls (HCs) from the multisite BSNIP (Bipolar-Schizophrenia Network on Intermediate Phenotypes) study. One million single-nucleotide polymorphisms (SNPs) were derived from DNA. We assessed eight data-driven EEG frequency activity derived from group-independent component analysis (ICA) in conjunction with a reduced subset of 10 422 SNPs through novel multivariate association using parallel ICA (para-ICA). Genes contributing to the association were examined collectively using pathway analysis tools. Para-ICA extracted five frequency and nine SNP components, of which theta and delta activities were significantly correlated with two different gene components, comprising genes participating extensively in brain development, neurogenesis and synaptogenesis. Delta and theta abnormality was present in both SZ and PBP, while theta differed between the two disorders. Theta abnormalities were also mediated by gene clusters involved in glutamic acid pathways, cadherin and synaptic contact-based cell adhesion processes. Our data suggest plausible multifactorial genetic networks, including novel and several previously identified (DISC1) candidate risk genes, mediating low frequency delta and theta abnormalities in psychoses. The gene clusters were enriched for biological properties affecting neural circuitry and involved in brain function and/or development. PMID:26101851

  12. Age and remission of personality pathology in the psychotic disorders compared to mood and/or anxiety disorders.

    PubMed

    Zhang, Tianhong; Good, Mary-Jo D; Good, Byron J; Chow, Annabelle; Wang, Lanlan; Dai, Yunfei; Xiao, Zeping

    2012-01-01

    In order to explore age-related differences in personality pathology between psychotic disorder (PSD) and mood and/or anxiety disorder (MAD) among psychiatric outpatients, 2,354 subjects were sampled randomly from outpatients in Shanghai and divided into two groups: PSD (N = 951) and MAD (N = 1403). Dimensional scores for personality disorder (PD) traits were assessed by using a self-reported personality diagnostic questionnaire (PDQ4+). Significant age differences were observed in most of the PD traits in MAD patients. Cluster B and C PD traits displayed an apparent decrease with age in MAD group, but such decline trend was not evident in PSD group. In both groups, the decline of self-reported Cluster A PD traits were less visible than the other clusters. Age-related mellowing of some PD traits such as "dramatic, erratic, anxious" occurred primarily in MAD patients; however the same traits in PSD patients appear to be less resistant to aging. Besides, "old eccentric" PD traits in both MAD and PSD patients seem to be maintained and less modified by aging. PMID:23586279

  13. Delusions related to infant and their association with mother-infant interactions in postpartum psychotic disorders.

    PubMed

    Chandra, P S; Bhargavaraman, R P; Raghunandan, V N G P; Shaligram, D

    2006-09-01

    The relationship between mother infant interactions and psychopathology in postpartum psychotic disorders has been recognised as being clinically important, however data in the field is sparse. The current study had two aims--firstly, to study the prevalence and nature of delusions towards the infant among mothers with postpartum onset severe mental illness and secondly, to study the association between delusional symptoms towards the infant and mother infant interactions. 108 consecutive women with onset of severe mental illness in the postpartum, who were admitted to an inpatient psychiatric unit in South India over a two-year period, were systematically assessed for presence of delusions related to the infant, using the Kannada version of the Birmingham Interview for Maternal Mental Health. Fifty-three percent of subjects reported delusions related to the infant, with 34% reporting more than one delusion. Mothers with infant related persecutory delusions were more likely to show affectionate behaviour and had normal competence and caring for baby's basic needs; however, they were more likely to get disturbed and agitated if separated from the baby. Mothers who had delusions that the baby was a devil or ill fated or someone else's baby, were more likely to have significant abusive incidents towards the baby. Overall, the mothers who had delusions related to the infant were seen to have more significant abusive incidents and were more likely to be considered unsafe in looking after the baby alone. The study emphasises the need for systematic clinical assessment of psychopathology in mothers with postpartum psychosis. PMID:16937315

  14. Spatial distribution of psychotic disorders in an urban area of France: an ecological study

    PubMed Central

    Pignon, Baptiste; Schürhoff, Franck; Baudin, Grégoire; Ferchiou, Aziz; Richard, Jean-Romain; Saba, Ghassen; Leboyer, Marion; Kirkbride, James B.; Szöke, Andrei

    2016-01-01

    Previous analyses of neighbourhood variations of non-affective psychotic disorders (NAPD) have focused mainly on incidence. However, prevalence studies provide important insights on factors associated with disease evolution as well as for healthcare resource allocation. This study aimed to investigate the distribution of prevalent NAPD cases in an urban area in France. The number of cases in each neighbourhood was modelled as a function of potential confounders and ecological variables, namely: migrant density, economic deprivation and social fragmentation. This was modelled using statistical models of increasing complexity: frequentist models (using Poisson and negative binomial regressions), and several Bayesian models. For each model, assumptions validity were checked and compared as to how this fitted to the data, in order to test for possible spatial variation in prevalence. Data showed significant overdispersion (invalidating the Poisson regression model) and residual autocorrelation (suggesting the need to use Bayesian models). The best Bayesian model was Leroux’s model (i.e. a model with both strong correlation between neighbouring areas and weaker correlation between areas further apart), with economic deprivation as an explanatory variable (OR = 1.13, 95% CI [1.02–1.25]). In comparison with frequentist methods, the Bayesian model showed a better fit. The number of cases showed non-random spatial distribution and was linked to economic deprivation. PMID:27189529

  15. Social functioning in patients with a psychotic disorder and first rank symptoms.

    PubMed

    Heering, Henriëtte D; van Haren, Neeltje E M

    2016-03-30

    There have been suggestions that a sense of self emerges through social interaction, which requires an intact capability to distinguish self from others. Here we investigated the contribution of first rank delusions and hallucinations, i.e. symptom expressions of a disturbed sense of self, to social functioning in patients with a psychotic disorder. Life-time and present-state positive symptom clusters (e.g. first rank delusions and hallucinations) and present-state negative symptoms were submitted to hierarchical multiple-regression analyses with (different domains of) social functioning as dependent variable. In addition to negative symptoms (β=-0.48), the life-time presence of first rank delusions is significantly negative associated with level of social functioning, in particular with the quality of interpersonal interactions, with a modest standardized regression coefficient (β=-0.14). We reconfirmed the well-established relationship between negative symptoms and social functioning, but the life-time presence of first rank delusions may also have an subtle ongoing effect on the quality of the interaction with others. We propose that the experience of first rank delusions may be an expression of enduring self-disturbances, leaving patients unsure on how to behave in social interactions. PMID:26892072

  16. Spatial distribution of psychotic disorders in an urban area of France: an ecological study.

    PubMed

    Pignon, Baptiste; Schürhoff, Franck; Baudin, Grégoire; Ferchiou, Aziz; Richard, Jean-Romain; Saba, Ghassen; Leboyer, Marion; Kirkbride, James B; Szöke, Andrei

    2016-01-01

    Previous analyses of neighbourhood variations of non-affective psychotic disorders (NAPD) have focused mainly on incidence. However, prevalence studies provide important insights on factors associated with disease evolution as well as for healthcare resource allocation. This study aimed to investigate the distribution of prevalent NAPD cases in an urban area in France. The number of cases in each neighbourhood was modelled as a function of potential confounders and ecological variables, namely: migrant density, economic deprivation and social fragmentation. This was modelled using statistical models of increasing complexity: frequentist models (using Poisson and negative binomial regressions), and several Bayesian models. For each model, assumptions validity were checked and compared as to how this fitted to the data, in order to test for possible spatial variation in prevalence. Data showed significant overdispersion (invalidating the Poisson regression model) and residual autocorrelation (suggesting the need to use Bayesian models). The best Bayesian model was Leroux's model (i.e. a model with both strong correlation between neighbouring areas and weaker correlation between areas further apart), with economic deprivation as an explanatory variable (OR = 1.13, 95% CI [1.02-1.25]). In comparison with frequentist methods, the Bayesian model showed a better fit. The number of cases showed non-random spatial distribution and was linked to economic deprivation. PMID:27189529

  17. Somatic Care with a Psychotic Disorder. Lower Somatic Health Care Utilization of Patients with a Psychotic Disorder Compared to Other Patient Groups and to Controls Without a Psychiatric Diagnosis.

    PubMed

    Swildens, Wilma; Termorshuizen, Fabian; de Ridder, Alex; Smeets, Hugo; Engelhard, Iris M

    2016-09-01

    Patients with non-affective psychotic disorders (NAPD) face higher risk of somatic problems and early natural death compared to the general population. Therefore, treatment guidelines for schizophrenia and psychosis stress the importance of monitoring somatic risk factors. This study examined somatic Health Care utilization (HCu) of patients with NAPD compared to non-psychiatric controls and patients with depression, anxiety or bipolar disorders using a large Health Insurance database. Results show lower specialist somatic HCu of patients with NAPD compared to matched controls and also lower percentages for prescribed somatic medication and general practitioner consultations for patients aged ≥60 years and after longer illness duration. PMID:26411564

  18. The health informatics cohort enhancement project (HICE): using routinely collected primary care data to identify people with a lifetime diagnosis of psychotic disorder

    PubMed Central

    2012-01-01

    Background We have previously demonstrated that routinely collected primary care data can be used to identify potential participants for trials in depression [1]. Here we demonstrate how patients with psychotic disorders can be identified from primary care records for potential inclusion in a cohort study. We discuss the strengths and limitations of this approach; assess its potential value and report challenges encountered. Methods We designed an algorithm with which we searched for patients with a lifetime diagnosis of psychotic disorders within the Secure Anonymised Information Linkage (SAIL) database of routinely collected health data. The algorithm was validated against the "gold standard" of a well established operational criteria checklist for psychotic and affective illness (OPCRIT). Case notes of 100 patients from a community mental health team (CMHT) in Swansea were studied of whom 80 had matched GP records. Results The algorithm had favourable test characteristics, with a very good ability to detect patients with psychotic disorders (sensitivity > 0.7) and an excellent ability not to falsely identify patients with psychotic disorders (specificity > 0.9). Conclusions With certain limitations our algorithm can be used to search the general practice data and reliably identify patients with psychotic disorders. This may be useful in identifying candidates for potential inclusion in cohort studies. PMID:22333117

  19. Facial expression to emotional stimuli in non-psychotic disorders: A systematic review and meta-analysis.

    PubMed

    Davies, H; Wolz, I; Leppanen, J; Fernandez-Aranda, F; Schmidt, U; Tchanturia, K

    2016-05-01

    Facial expression of emotion is crucial to social interaction and emotion regulation; therefore, altered facial expressivity can be a contributing factor in social isolation, difficulties with emotion regulation and a target for therapy. This article provides a systematic review and meta-analysis of the literature on automatic emotional facial expression in people with non-psychotic disorders compared to healthy comparison groups. Studies in the review used an emotionally salient visual induction method, and reported on automatic facial expression in response to congruent stimuli. A total of 39 studies show alterations in emotional facial expression across all included disorders, except anxiety disorders. In depression, decreases in facial expression are mainly evident for positive affect. In eating disorders, a meta-analysis showed decreased facial expressivity in response to positive and negative stimuli. Studies in autism partially support generally decreased facial expressivity in this group. The data included in this review point towards decreased facial emotional expressivity in individuals with different non-psychotic disorders. This is the first review to synthesise facial expression studies across clinical disorders. PMID:26915928

  20. Corpus callosum area in patients with bipolar disorder with and without psychotic features: an international multicentre study

    PubMed Central

    Sarrazin, Samuel; d’Albis, Marc-Antoine; McDonald, Colm; Linke, Julia; Wessa, Michèle; Phillips, Mary; Delavest, Marine; Emsell, Louise; Versace, Amelia; Almeida, Jorge; Mangin, Jean-François; Poupon, Cyril; Le Dudal, Katia; Daban, Claire; Hamdani, Nora; Leboyer, Marion; Houenou, Josselin

    2015-01-01

    Background Previous studies have reported MRI abnormalities of the corpus callosum (CC) in patients with bipolar disorder (BD), although only a few studies have directly compared callosal areas in psychotic versus nonpsychotic patients with this disorder. We sought to compare regional callosal areas in a large international multicentre sample of patients with BD and healthy controls. Methods We analyzed anatomic T1 MRI data of patients with BD-I and healthy controls recruited from 4 sites (France, Germany, Ireland and the United States). We obtained the mid-sagittal areas of 7 CC subregions using an automatic CC delineation. Differences in regional callosal areas between patients and controls were compared using linear mixed models (adjusting for age, sex, handedness, brain volume, history of alcohol abuse/dependence, lithium or antipsychotic medication status, symptomatic status and site) and multiple comparisons correction. We also compared regional areas of the CC between patients with BD with and without a history of psychotic features. Results We included 172 patients and 146 controls in our study. Patients with BD had smaller adjusted mid-sagittal CC areas than controls along the posterior body, the isthmus and the splenium of the CC. Patients with a positive history of psychotic features had greater adjusted area of the rostral CC region than those without a history of psychotic features. Limitations We found small to medium effect sizes, and there was no calibration technique among the sites. Conclusion Our results suggest that BD with psychosis is associated with a different pattern of interhemispheric connectivity than BD without psychosis and could be considered a relevant neuroimaging subtype of BD. PMID:26151452

  1. An Open Trial of a New Acceptance-Based Behavioral Treatment for Major Depression with Psychotic Features

    ERIC Educational Resources Information Center

    Gaudiano, Brandon A.; Nowlan, Kathryn; Brown, Lily A.; Epstein-Lubow, Gary; Miller, Ivan W.

    2013-01-01

    Research suggests that cognitive and behavioral therapies produce significant benefits over medications alone in the treatment of severe, nonpsychotic major depression or primary psychotic disorders such as schizophrenia. However, previous research has not demonstrated the efficacy of psychotherapy for major depression with psychotic features. In…

  2. Genome-wide association of mood-incongruent psychotic bipolar disorder

    PubMed Central

    Goes, F S; Hamshere, M L; Seifuddin, F; Pirooznia, M; Belmonte-Mahon, P; Breuer, R; Schulze, T; Nöthen, M; Cichon, S; Rietschel, M; Holmans, P; Zandi, P P; Craddock, N; Potash, J B

    2012-01-01

    Mood-incongruent psychotic features (MICP) are familial symptoms of bipolar disorder (BP) that also occur in schizophrenia (SZ), and may represent manifestations of shared etiology between the major psychoses. In this study we have analyzed three large samples of BP with imputed genome-wide association data and have performed a meta-analysis of 2196 cases with MICP and 8148 controls. We found several regions with suggestive evidence of association (P<10–6), although no marker met genome-wide significance criteria. The top associations were on chromosomes: 6q14.2 within the PRSS35/SNAP91 gene complex (rs1171113, P=9.67 × 10–8); 3p22.2 downstream of TRANK/LBA1 (rs9834970, P=9.71 × 10–8); and 14q24.2 in an intron of NUMB (rs2333194, P=7.03 × 10–7). These associations were present in all three samples, and both rs1171113 and rs2333194 were found to be overrepresented in an analysis of MICP cases compared with all other BP cases. To test the relationship of MICP with SZ, we performed polygenic analysis using the Psychiatric GWAS Consortium SZ results and found evidence of association between SZ polygenes and the presence of MICP in BP cases (meta-analysis P=0.003). In summary, our analysis of the MICP phenotype in BP has provided suggestive evidence for association of common variants in several genes expressed in the nervous system. The results of our polygenic analysis provides support for a modest degree of genetic overlap between BP with MICP and SZ, highlighting that phenotypic correlations across syndromes may be due to the influence of polygenic risk factors. PMID:23092984

  3. Copy Number Variants for Schizophrenia and Related Psychotic Disorders in Oceanic Palau: Risk and Transmission in Extended Pedigrees

    PubMed Central

    Melhem, Nadine; Middleton, Frank; McFadden, Kathryn; Klei, Lambertus; Faraone, Stephen V; Vinogradov, Sophia; Tiobech, Josepha; Yano, Victor; Kuartei, Stevenson; Roeder, Kathryn; Byerley, William; Devlin, Bernie; Myles-Worsley, Marina

    2011-01-01

    Background We report on copy number variants (CNVs) found in Palauan subjects ascertained for schizophrenia and related psychotic disorders in extended pedigrees in Palau. We compare CNVs found in this Oceanic population to those seen in other samples, typically of European ancestry. Assessing CNVs in Palauan extended pedigrees yields insight into the evolution of risk CNVs, such as how they arise, are transmitted, and are lost from populations by stochastic or selective processes, none of which is easily measured from case-control samples. Methods DNA samples from 197 subjects affected with schizophrenia and related psychotic disorders, 185 of their relatives, and 159 controls were successfully characterized for CNVs using Affymetrix Genomewide Human SNP Array 5.0. Results CNVs thought to be associated with risk for schizophrenia and related disorders also occur in affected individuals in Palau, specifically 15q11.2 and 1q21.1 deletions, partial duplication of IL1RAPL1 (Xp21.3), and chromosome X duplications (Klinefleter’s syndrome). Partial duplication within A2BP1 appears to convey an 8-fold increased risk in males (95% CI, 0.8–84.4) but not females (OR=0.4, 95% CI, 0.03–4.9). Affected-only linkage analysis using this variant yields a LOD score of 3.5. Conclusions This study reveals CNVs that confer risk to schizophrenia and related psychotic disorders in Palau, most of which have been previously observed in samples of European ancestry. Only a few of these CNVs show evidence that they have existed for many generations, consistent with risk variants diminishing reproductive success. PMID:21982423

  4. Fluvoxamine monotherapy for psychotic depression: the potential role of sigma-1 receptors

    PubMed Central

    2009-01-01

    Background Psychotic depression is a clinical subtype of major depressive disorder. A number of clinical studies have demonstrated the efficacy of the combination of an antidepressant (for example, a tricyclic antidepressant or selective serotonin reuptake inhibitor (SSRI)) and an atypical antipsychotic or electroconvulsive therapy in treating psychotic depression. In some cases, the clinician or patient may prefer to avoid antipsychotic drugs altogether because of the risk of extrapyramidal side effects (EPS) in patients with psychotic depression treated with these drugs. Methods We report five cases where fluvoxamine monotherapy was effective in the patients with psychotic depression. Results The scores on the Hamilton Depression (HAM-D) scale and the Brief Psychiatric Rating Scale (BPRS) in the five patients with psychotic depression were reduced after fluvoxamine monotherapy. Conclusion Doctors should consider fluvoxamine monotherapy as an alternative approach in treating psychotic depression because it avoids the risk of EPS from antipsychotic drugs. PMID:20025739

  5. An Approach to Maximizing Treatment Adherence of Children and Adolescents with Psychotic Disorders and Major Mood Disorders

    PubMed Central

    Gearing, Robin Edward; Mian, Irfan A.

    2005-01-01

    Introduction Mental health research has consistently focused on high rates of treatment non-adherence, and how inpatient programs and health professionals can effectively confront this reality. The literature has centred almost exclusively on adult populations. Unfortunately, psychotic and major mood disorders are serious and persistent mental health problems that are increasingly recognized as having an early onset, affecting children and adolescents. Method This article draws on a review of the literature and Habermas’s three domains of knowledge: technical, practical, and emancipatory. This article has incorporated current research, adherence theories, and the facilitation of the unique local expertise of health professionals to generate a framework. This framework is designed to teach health professionals working in child and adolescent psychiatric inpatient units how they and the larger unit can practice to enhance patient treatment adherence during and after admission. Results A five-step approach to teach health professionals to enhance treatment adherence has been developed based on current research and educational theories and principles. Conclusion Health professionals working in child and adolescent psychiatry can practice to enhance patient treatment adherence, and improve patient and family outcomes. PMID:19030524

  6. Association between Genetic Variation in the Oxytocin Receptor Gene and Emotional Withdrawal, but not between Oxytocin Pathway Genes and Diagnosis in Psychotic Disorders

    PubMed Central

    Haram, Marit; Tesli, Martin; Bettella, Francesco; Djurovic, Srdjan; Andreassen, Ole Andreas; Melle, Ingrid

    2015-01-01

    Social dysfunction is common in patients with psychotic disorders. Oxytocin is a neuropeptide with a central role in social behavior. This study aims to explore the relationship between oxytocin pathway genes and symptoms related to social dysfunction in patients with psychotic disorders. We performed association analyses between four oxytocin pathway genes (OXT, OXTR, AVP, and CD38) and four areas of social behavior-related psychopathology as measured by Positive and Negative Syndrome Scale. For this purpose, we used both a polygenic risk score (PGRS) and single OXTR candidate single nucleotide polymorphism previously reported in the literature (rs53576, rs237902, and rs2254298). A total of 734 subjects with DSM-IV psychotic spectrum disorders and 420 healthy controls were included. Oxytocin pathway PGRSs were calculated based on the independent Psychiatric Genomics Consortium study sample. There was a significant association between symptom of Emotional Withdrawal and the previously reported OXTR risk allele A in rs53576. No significant associations between oxytocin pathway gene variants and a diagnosis of psychotic disorder were found. Our findings indicate that while oxytocin pathway genes do not appear to contribute to the susceptibility to psychotic disorders, variations in the OXTR gene might play a role in the development of impaired social behavior. PMID:25667571

  7. Personality Compensates for Impaired Quality of Life and Social Functioning in Patients With Psychotic Disorders Who Experienced Traumatic Events

    PubMed Central

    Boyette, Lindy-Lou; van Dam, Daniëlla; Meijer, Carin; Velthorst, Eva; Cahn, Wiepke; de Haan, Lieuwe; Kahn, René; de Haan, Lieuwe; van Os, Jim; Wiersma, Durk; Bruggeman, Richard; Cahn, Wiepke; Meijer, Carin; Myin-Germeys, Inez

    2014-01-01

    Background: Patients with psychotic disorders who experienced childhood trauma show more social dysfunction than patients without traumatic experiences. However, this may not hold for all patients with traumatic experiences. Little is known about the potential compensating role of Five-Factor Model personality traits within this group, despite their strong predictive value for social functioning and well-being in the general population. Methods: Our sample consisted of 195 patients with psychotic disorders (74% diagnosed with schizophrenia) and 132 controls. Cluster analyses were conducted to identify and validate distinct personality profiles. General linear model analyses were conducted to examine whether patients with different profiles differed in social functioning and quality of life (QoL), while controlling for possible confounders. Mediation models were tested to assess potential causal links. Results: In general, patients with higher levels of self-reported traumatic experiences (PT+) showed lower QoL and more social withdrawal compared with patients with lower traumatic experiences (PT−). Two clusters reflecting personality profiles were identified. PT+ with the first profile (lower neuroticism and higher extraversion, openness, agreeableness, and conscientiousness) presented higher levels of QoL and better social functioning in several areas, including less withdrawal, compared with both PT+ and PT− with the second profile. PT+ and PT− with the first personality profile did not differ in QoL and social functioning. Mediation analyses suggested that personality traits mediate the relation between traumatic experiences and QoL and social withdrawal. Conclusions: Our findings indicate that personality may “buffer” the impact of childhood traumatic experiences on functional outcome in patients with psychotic disorders. PMID:24771304

  8. Cognitive Performance and Long-Term Social Functioning in Psychotic Disorder: A Three-Year Follow-Up Study

    PubMed Central

    Simons, Claudia J. P.; Bartels-Velthuis, Agna A.; Pijnenborg, Gerdina H. M.

    2016-01-01

    Objective Studies have linked cognitive functioning to everyday social functioning in psychotic disorders, but the nature of the relationships between cognition, social cognition, symptoms, and social functioning remains unestablished. Modelling the contributions of non-social and social cognitive ability in the prediction of social functioning may help in more clearly defining therapeutic targets to improve functioning. Method In a sample of 745 patients with a non-affective psychotic disorder, the associations between cognition and social cognition at baseline on the one hand, and self-reported social functioning three years later on the other, were analysed. First, case-control comparisons were conducted; associations were subsequently further explored in patients, investigating the potential mediating role of symptoms. Analyses were repeated in a subsample of 233 patients with recent-onset psychosis. Results Information processing speed and immediate verbal memory were stronger associated with social functioning in patients than in healthy controls. Most cognition variables significantly predicted social functioning at follow-up, whereas social cognition was not associated with social functioning. Symptoms were robustly associated with follow-up social functioning, with negative symptoms fully mediating most associations between cognition and follow-up social functioning. Illness duration did not moderate the strength of the association between cognitive functioning and follow-up social functioning. No associations were found between (social) cognition and follow-up social functioning in patients with recent-onset psychosis. Conclusions Although cognitive functioning is associated with later social functioning in psychotic disorder, its role in explaining social functioning outcome above negative symptoms appears only modest. In recent-onset psychosis, cognition may have a negligible role in predicting later social functioning. Moreover, social cognition tasks

  9. The KMO allele encoding Arg452 is associated with psychotic features in bipolar disorder type 1, and with increased CSF KYNA level and reduced KMO expression.

    PubMed

    Lavebratt, C; Olsson, S; Backlund, L; Frisén, L; Sellgren, C; Priebe, L; Nikamo, P; Träskman-Bendz, L; Cichon, S; Vawter, M P; Osby, U; Engberg, G; Landén, M; Erhardt, S; Schalling, M

    2014-03-01

    The kynurenine pathway metabolite kynurenic acid (KYNA), modulating glutamatergic and cholinergic neurotransmission, is increased in cerebrospinal fluid (CSF) of patients with schizophrenia or bipolar disorder type 1 with psychotic features. KYNA production is critically dependent on kynurenine 3-monooxygenase (KMO). KMO mRNA levels and activity in prefrontal cortex (PFC) are reduced in schizophrenia. We hypothesized that KMO expression in PFC would be reduced in bipolar disorder with psychotic features and that a functional genetic variant of KMO would associate with this disease, CSF KYNA level and KMO expression. KMO mRNA levels were reduced in PFC of bipolar disorder patients with lifetime psychotic features (P=0.005, n=19) or schizophrenia (P=0.02, n=36) compared with nonpsychotic patients and controls. KMO genetic association to psychotic features in bipolar disorder type 1 was studied in 493 patients and 1044 controls from Sweden. The KMO Arg(452) allele was associated with psychotic features during manic episodes (P=0.003). KMO Arg(452) was studied for association to CSF KYNA levels in an independent sample of 55 Swedish patients, and to KMO expression in 717 lymphoblastoid cell lines and 138 hippocampal biopsies. KMO Arg(452) associated with increased levels of CSF KYNA (P=0.03) and reduced lymphoblastoid and hippocampal KMO expression (P≤0.05). Thus, findings from five independent cohorts suggest that genetic variation in KMO influences the risk for psychotic features in mania of bipolar disorder patients. This provides a possible mechanism for the previous findings of elevated CSF KYNA levels in those bipolar patients with lifetime psychotic features and positive association between KYNA levels and number of manic episodes. PMID:23459468

  10. Mood disorder with mixed, psychotic features due to vitamin b12 deficiency in an adolescent: case report

    PubMed Central

    2012-01-01

    Vitamin B12 is one of the essential vitamins affecting various systems of the body. Reports of psychiatric disorders due to its deficiency mostly focus on middle aged and elderly patients. Here we report a case of vitamin B 12 deficiency in a 16-year old, male adolescent who presented with mixed mood disorder symptoms with psychotic features. Chief complaints were “irritability, regressive behavior, apathy, crying and truancy” which lasted for a year. Premorbid personality was unremarkable with no substance use/exposure or infections. No stressors were present. The patient was not vegetarian. Past medical history and family history was normal. Neurological examination revealed glossitis, ataxia, rigidity in both shoulders, cog-wheel rigidity in the left elbow, bilateral problems of coordination in cerebellar examination, reduced swinging of the arms and masked face. Romberg’s sign was present. Laboratory evaluations were normal. Endoscopy and biopsy revealed atrophy of the gastric mucosa with Helicobacter Pylori colonization. Schilling test was suggestive of malabsorbtion. He was diagnosed with Mood disorder with Mixed, Psychotic Features due to Vitamin B12 Deficiency and risperidone 0.5 mg/day and intramuscular vitamin B12 500 mcg/day were started along with referral for treatment of Helicobacter pylori. A visit on the second week revealed no psychotic features. Romberg’s sign was negative and cerebellar tests were normal. Extrapyramidal symptoms were reduced while Vitamin B12 levels were elevated. Risperidone was stopped and parenteral Vitamin B12 treatment was continued with monthly injections for 3 months. Follow-up endoscopy and biopsy at the first month demonstrated eradication of H. pylori. He was followed monthly for another 6 months and psychiatric symptoms did not recur at the time of last evaluation. Despite limitations, this case may underline the observation that mood disorders with psychotic features especially with accompanying

  11. Mood disorder with mixed, psychotic features due to vitamin b12 deficiency in an adolescent: case report.

    PubMed

    Tufan, Ali Evren; Bilici, Rabia; Usta, Genco; Erdoğan, Ayten

    2012-01-01

    Vitamin B12 is one of the essential vitamins affecting various systems of the body. Reports of psychiatric disorders due to its deficiency mostly focus on middle aged and elderly patients. Here we report a case of vitamin B 12 deficiency in a 16-year old, male adolescent who presented with mixed mood disorder symptoms with psychotic features. Chief complaints were "irritability, regressive behavior, apathy, crying and truancy" which lasted for a year. Premorbid personality was unremarkable with no substance use/exposure or infections. No stressors were present. The patient was not vegetarian. Past medical history and family history was normal. Neurological examination revealed glossitis, ataxia, rigidity in both shoulders, cog-wheel rigidity in the left elbow, bilateral problems of coordination in cerebellar examination, reduced swinging of the arms and masked face. Romberg's sign was present. Laboratory evaluations were normal. Endoscopy and biopsy revealed atrophy of the gastric mucosa with Helicobacter Pylori colonization. Schilling test was suggestive of malabsorbtion. He was diagnosed with Mood disorder with Mixed, Psychotic Features due to Vitamin B12 Deficiency and risperidone 0.5 mg/day and intramuscular vitamin B12 500 mcg/day were started along with referral for treatment of Helicobacter pylori. A visit on the second week revealed no psychotic features. Romberg's sign was negative and cerebellar tests were normal. Extrapyramidal symptoms were reduced while Vitamin B12 levels were elevated. Risperidone was stopped and parenteral Vitamin B12 treatment was continued with monthly injections for 3 months. Follow-up endoscopy and biopsy at the first month demonstrated eradication of H. pylori. He was followed monthly for another 6 months and psychiatric symptoms did not recur at the time of last evaluation. Despite limitations, this case may underline the observation that mood disorders with psychotic features especially with accompanying extrapyramidal

  12. Cabergoline can induce mania with psychotic features in bipolar I disorder: a case report.

    PubMed

    Rovera, Chiara; Cremaschi, Laura; Thanju, Amod; Fiorentini, Alessio; Mauri, Massimo Carlo; Serati, Marta; Lindenmayer, Jean Pierre; Altamura, A Carlo

    2016-08-01

    Up to date, only a small evidence of psychosis induced by cabergoline is available in literature. Herein, the case of a 34-year-old bipolar patient treated with cabergoline has been described. Cabergoline is generally a safe and effective method of reducing prolactin levels and it may be associated with psychiatric side effects, including psychotic features. PMID:27520906

  13. Self-disorders in individuals with attenuated psychotic symptoms: Contribution of a dysfunction of autobiographical memory.

    PubMed

    Berna, Fabrice; Göritz, Anja S; Schröder, Johanna; Martin, Brice; Cermolacce, Michel; Allé, Mélissa C; Danion, Jean-Marie; Cuervo-Lombard, Christine V; Moritz, Steffen

    2016-05-30

    Patients with schizophrenia and people with subclinical psychotic symptoms have difficulties getting a clear and stable representation of their self. The cognitive mechanisms involved in this reduced clarity of self-concept remain poorly understood. The present study examined whether an altered way of thinking or reasoning about one's past may account for the reduced clarity of self-concept in individuals with attenuated psychotic symptoms (APS). An online study comprising 667 participants examined the capacity to give a meaning to past events and to scrutinize autobiographical memory to better understand him/herself. Our results showed that in this sample, individuals with APS (n=49) have a lower clarity of self-concept and a higher tendency to scrutinize autobiographical memory than controls subjects (n=147). A mediation analysis performed on the full sample revealed that the relation between APS and clarity of self-concept was mediated by a tendency to scrutinize autobiographical memory. Our results suggest that the weakness of self-concept, which increases with the intensity of psychotic symptoms, may be related to an altered function of autobiographical memory, so that examining past events may fail to sustain a stable and clear representation of the self when psychotic symptoms increase. PMID:27058160

  14. The CCC2000 Birth Cohort Study of Register-Based Family History of Mental Disorders and Psychotic Experiences in Offspring.

    PubMed

    Jeppesen, Pia; Larsen, Janne Tidselbak; Clemmensen, Lars; Munkholm, Anja; Rimvall, Martin Kristian; Rask, Charlotte Ulrikka; van Os, Jim; Petersen, Liselotte; Skovgaard, Anne Mette

    2015-09-01

    Psychotic experiences (PE) in individuals of the general population are hypothesized to mark the early expression of the pathology underlying psychosis. This notion of PE as an intermediate phenotype is based on the premise that PE share genetic liability with psychosis. We examined whether PE in childhood was predicted by a family history of mental disorder with psychosis rather than a family history of nonpsychotic mental disorder and whether this association differed by severity of PE. The study examined data on 1632 children from a general population birth cohort assessed at age 11-12 years by use of a semistructured interview covering 22 psychotic symptoms. The Danish national registers were linked to describe the complete family history of hospital-based psychiatric diagnoses. Uni- and multivariable logistic regressions were used to test whether a family history of any mental disorder with psychosis, or of nonpsychotic mental disorder, vs no diagnoses was associated with increased risk of PE in offspring (hierarchical exposure variable). The occurrence of PE in offspring was significantly associated with a history of psychosis among the first-degree relatives (adjusted relative risk [RR] = 3.29, 95% CI: 1.82-5.93). The risk increased for combined hallucinations and delusions (adjusted RR = 5.90, 95% CI: 2.64-13.16). A history of nonpsychotic mental disorders in first-degree relatives did not contribute to the risk of PE in offspring nor did any mental disorder among second-degree relatives. Our findings support the notion of PE as a vulnerability marker of transdiagnostic psychosis. The effect of psychosis in first-degree relatives may operate through shared genetic and environmental factors. PMID:25452427

  15. Prefrontal NAA and Glx Levels in Different Stages of Psychotic Disorders: a 3T 1H-MRS Study.

    PubMed

    Liemburg, Edith; Sibeijn-Kuiper, Anita; Bais, Leonie; Pijnenborg, Gerdina; Knegtering, Henderikus; van der Velde, Jorien; Opmeer, Esther; de Vos, Annerieke; Dlabac-De Lange, Jozarni; Wunderink, Lex; Aleman, André

    2016-01-01

    H-Magnetic Resonance Spectroscopy ((1)H-MRS) can offer insights in various neuropathologies by measuring metabolite levels in the brain. In the current study we investigated the levels of glutamate + glutamine (Glx, neurotransmitter and precursor) and N-Acetyl Aspartate + glutamic acid (NAA + NAAG; neuronal viability) in the prefrontal cortex of patients with a psychotic disorder and people at Ultra High Risk (UHR) for psychosis. A (1)H-MRS spectrum was acquired in 31 patients with a recent onset psychotic disorder and 60 with a chronic state, 16 UHR patients and 36 healthy controls. Absolute metabolite levels were calculated using LCModel with a reference water peak. Groups were compared while taking into account age and partial volume effects. Moreover, we investigated associations with positive and negative symptoms, duration of illness, and antipsychotic treatment in patients. The most notable finding is that chronicity of schizophrenia was related to decreased levels of Glx and NAA. On the other hand, although on an exploratory note, UHR showed increased levels of prefrontal Glx and NAA levels with increasing age. Our results may indicate an initial Glx and NAA increase and subsequent decrease during illness progression that may be related to the neurotoxic effects of glutamate. PMID:26903078

  16. Temperament and Character in Euthymic Major Depressive Disorder Patients: The Effect of Previous Suicide Attempts and Psychotic Mood Episodes

    PubMed Central

    Albayrak, Yakup; Ekinci, Aslı Erkan

    2012-01-01

    Objective The purpose of this study was to examine personality traits of patients with major depressive disorder and explore the possible connections between personality and clinical and sociodemographic variables. Methods The sociodemographic and clinical properties of 80 patients with major depression, who were euthymic according to Hamilton Depression Scale scores, were recorded. Their personality was evaluated by using Temperament and Character Inventory and results were compared with 80 age- and sex-matched healthy controls. We used general linear model analysis to evaluate the manner in which the variables contributed to TCI scores. Results Remitted depressive patients scored significantly lower on on self-directedness and higher on harm avoidance than HC. Previous suicide attempts had a main effect only on harm avoidance while previous psychotic mood episodes were significantly associated with novelty seeking, self-directedness and cooperativeness. With respect to numeric clinical variables, only duration of illness was significantly and negatively correlated with NS and RD scores. Conclusion Patients with euthymic major depressive disorder may have significantly different personality traits than the normal population, and patients with different clinical and sociodemographic characteristics may show different personality patterns. In addition, assessment of major depressed patients by means of the Temperament and Character Inventory may be helpful to get a deeper insight into those personality traits underlying suicidality and the emergence of psychotic mood episode. PMID:22707961

  17. Depot-medication compliance for patients with psychotic disorders: the importance of illness insight and treatment motivation

    PubMed Central

    Noordraven, Ernst L; Wierdsma, André I; Blanken, Peter; Bloemendaal, Anthony FT; Mulder, Cornelis L

    2016-01-01

    Background Noncompliance is a major problem for patients with a psychotic disorder. Two important risk factors for noncompliance that have a severe negative impact on treatment outcomes are impaired illness insight and lack of motivation. Our cross-sectional study explored how they are related to each other and their compliance with depot medication. Methods Interviews were conducted in 169 outpatients with a psychotic disorder taking depot medication. Four patient groups were defined based on low or high illness insight and on low or high motivation. The associations between depot-medication compliance, motivation, and insight were illustrated using generalized linear models. Results Generalized linear model showed a significant interaction effect between motivation and insight. Patients with poor insight and high motivation for treatment were more compliant (94%) (95% confidence interval [CI]: 1.821, 3.489) with their depot medication than patients with poor insight and low motivation (61%) (95% CI: 0.288, 0.615). Patients with both insight and high motivation for treatment were less compliant (73%) (95% CI: 0.719, 1.315) than those with poor insight and high motivation. Conclusion Motivation for treatment was more strongly associated with depot-medication compliance than with illness insight. Being motivated to take medication, whether to get better or for other reasons, may be a more important factor than having illness insight in terms of improving depot-medication compliance. Possible implications for clinical practice are discussed. PMID:26893565

  18. Prefrontal NAA and Glx Levels in Different Stages of Psychotic Disorders: a 3T 1H-MRS Study

    PubMed Central

    Liemburg, Edith; Sibeijn-Kuiper, Anita; Bais, Leonie; Pijnenborg, Gerdina; Knegtering, Henderikus; van der Velde, Jorien; Opmeer, Esther; de Vos, Annerieke; Dlabac-De Lange, Jozarni; Wunderink, Lex; Aleman, André

    2016-01-01

    H-Magnetic Resonance Spectroscopy (1H-MRS) can offer insights in various neuropathologies by measuring metabolite levels in the brain. In the current study we investigated the levels of glutamate + glutamine (Glx, neurotransmitter and precursor) and N-Acetyl Aspartate + glutamic acid (NAA + NAAG; neuronal viability) in the prefrontal cortex of patients with a psychotic disorder and people at Ultra High Risk (UHR) for psychosis. A 1H-MRS spectrum was acquired in 31 patients with a recent onset psychotic disorder and 60 with a chronic state, 16 UHR patients and 36 healthy controls. Absolute metabolite levels were calculated using LCModel with a reference water peak. Groups were compared while taking into account age and partial volume effects. Moreover, we investigated associations with positive and negative symptoms, duration of illness, and antipsychotic treatment in patients. The most notable finding is that chronicity of schizophrenia was related to decreased levels of Glx and NAA. On the other hand, although on an exploratory note, UHR showed increased levels of prefrontal Glx and NAA levels with increasing age. Our results may indicate an initial Glx and NAA increase and subsequent decrease during illness progression that may be related to the neurotoxic effects of glutamate. PMID:26903078

  19. Life-threatening ketoacidosis in a pregnant woman with psychotic disorder.

    PubMed

    Frise, Charlotte; Attwood, Ben; Watkinson, Peter; Mackillop, Lucy

    2016-03-01

    Pregnancy is an insulin resistant state. Hyperglycaemia and gestational diabetes mellitus are well-recognised complications even in women without existing metabolic syndrome or obesity. Pregnant women also appear to be more vulnerable to ketoacidosis, particularly after short periods of reduced oral intake in the third trimester, and may present with very severe starvation ketoacidosis, prompting emergent delivery. We present a case of a woman with a background of depression and psychotic episodes. Olanzapine had been commenced after a psychotic episode at 20 weeks' gestation. Gestational diabetes mellitus was diagnosed at 28 weeks, and she was then admitted at 31 weeks with severe euglycaemic ketoacidosis following a short period of vomiting. She underwent caesarean section when the metabolic disturbances did not resolve with medical treatment. We believe atypical antipsychotic therapy contributed to the profound insulin resistance seen here, and that obstetricians, physicians and psychiatrists must be aware of the risks conferred by these agents in pregnancy. PMID:27512491

  20. Neuroimaging and treatment evidence for clinical staging in psychotic disorders: from the at-risk mental state to chronic schizophrenia.

    PubMed

    Wood, Stephen J; Yung, Alison R; McGorry, Patrick D; Pantelis, Christos

    2011-10-01

    A new approach to understanding severe mental disorders such as schizophrenia is to adopt a clinical staging model. Such a model defines the extent of the illness such that earlier and milder phenomena are distinguished from later, more impairing features. Specifically, a clinical staging model makes three key predictions. First, pathologic measures should be more abnormal in more severe stages. Second, patients who progress between the stages should show change in these same pathologic measures. Finally, treatment should be more effective in the earlier stages, as well as more benign. In this article, we review the evidence for these three predictions from studies of psychotic disorders, with a focus on neuroimaging data. For all three, the balance of evidence supports the predictions of the staging model. However, there are a number of alternative explanations for these findings, including the effects of medication and symptom heterogeneity. PMID:21762875

  1. The Serotonin Transporter 5-HTTPR Polymorphism is associated with Current and Lifetime Depression in Persons with Chronic Psychotic Disorders

    PubMed Central

    Contreras, Javier; Hare, Liz; Camarena, Beatriz; Glahn, David; Dassori, Albana; Medina, Rolando; Contrerasa, Salvador; Ramirez, Mercedes; Armas, Regina; Munoz, Rodrigo; Mendoza, Rick; Raventos, Henriette; Ontiveros, Alfonso; Nicolini, Humberto; Palmer, Raymond; Escamilla, Michael

    2013-01-01

    Objective Variation in the serotonin transporter gene (SLC6A4) promoter region has been shown to influence depression in persons who have been exposed to a number of stressful life events. Method We evaluated whether genetic variation in 5-HTTLPR, influences current depression, lifetime history of depression and quantitative measures of depression in persons with chronic psychotic disorders. This is an association study of a genetic variant with quantitative and categorical definitions of depression conducted in the Southwest United States, Mexico, and Costa Rica. We analyzed 260 subjects with a history of psychosis, from a sample of 129 families. Results We found that persons carrying at least one short allele had a statistically significant increased lifetime risk for depressive syndromes (p<.02, Odds Ratio=2.18, 95% CI=1.10–4.20). Conclusion The “ss” or “sl” genotype at the 5-HTTLPR promoter polymorphic locus increases the risk of psychotic individuals to develop major depression during the course of their illness. PMID:19016667

  2. The Relationship Between Educational Years and Phonemic Verbal Fluency (PVF) and Semantic Verbal Fluency (SVF) Tasks in Spanish Patients Diagnosed With Schizophrenia, Bipolar Disorder, and Psychotic Bipolar Disorder

    PubMed Central

    García-Laredo, Eduardo; Maestú, Fernando; Castellanos, Miguel Ángel; Molina, Juan D.; Peréz-Moreno, Elisa

    2015-01-01

    Abstract Semantic and verbal fluency tasks are widely used as a measure of frontal capacities. It has been well described in literature that patients affected by schizophrenic and bipolar disorders present a worse execution in these tasks. Some authors have also noted the importance of educational years. Our objective is to analyze whether the effect of cognitive malfunction caused by apathology is superior to the expected effect of years of education in phonemic verbal fluency (PVF) and semantic verbal fluency (SVF) task execution. A total of 62 individuals took part in this study, out of which 23 were patients with schizophrenic paranoid disorder, 11 suffered from bipolar disorder with psychotic symptomatology, 13 suffered from bipolar disorder without psychotic symptomatology, and 15 participants were nonpathological individuals. All participants were evaluated with the PVF and SVF tests (animals and tools). The performance/execution results were analyzed with a mixed-model ANCOVA, with educational years as a covariable. The effect of education seems to be more determined by PVF FAS tests than by SVF. With PVF FAS tasks, the expected effect of pathology disappears when the covariable EDUCATION is introduced. With SVF tasks, the effect continues to be significant, even though the EDUACTION covariable dims such effect. These results suggest that SVF tests (animals category) are better evaluation tools as they are less dependent on the patients’ education than PVF FAS tests. PMID:26426640

  3. Epidemiological and Clinical Characterization Following a First Psychotic Episode in Major Depressive Disorder: Comparisons With Schizophrenia and Bipolar I Disorder in the Cavan-Monaghan First Episode Psychosis Study (CAMFEPS)

    PubMed Central

    O’Callaghan, Eadbhard; Waddington, John L.

    2013-01-01

    While recent research on psychotic illness has focussed on the nosological, clinical, and biological relationships between schizophrenia and bipolar disorder, little attention has been directed to the most common other psychotic diagnosis, major depressive disorder with psychotic features (MDDP). As this diagnostic category captures the confluence between dimensions of psychotic and affective psychopathology, it is of unappreciated heuristic potential to inform on the nature of psychotic illness. Therefore, the epidemiology and clinical characteristics of MDDP were compared with those of schizophrenia and bipolar disorder within the Cavan-Monaghan First Episode Psychosis Study (n = 370). Epidemiologically, the first psychotic episode of MDDP (n = 77) was uniformly distributed across the adult life span, while schizophrenia (n = 73) and bipolar disorder (n = 73) were primarily disorders of young adulthood; the incidence of MDDP, like bipolar disorder, did not differ between the sexes, while the incidence of schizophrenia was more common in males than in females. Clinically, MDDP was characterized by negative symptoms, executive dysfunction, neurological soft signs (NSS), premorbid intellectual function, premorbid adjustment, and quality of life similar to those for schizophrenia, while bipolar disorder was characterized by less prominent negative symptoms, executive dysfunction and NSS, and better quality of life. These findings suggest that what we currently categorize as MDDP may be more closely aligned with other psychotic diagnoses than has been considered previously. They indicate that differences in how psychosis is manifested vis-à-vis depression and mania may be quantitative rather than qualitative and occur within a dimensional space, rather than validating categorical distinctions. PMID:23716714

  4. Electroconvulsive Therapy Treatment in a Patient With Neurosyphilis and Psychotic Disorder: Case Report and Literature Review.

    PubMed

    Pecenak, Jan; Janik, Peter; Vaseckova, Barbora; Trebulova, Kristina

    2015-12-01

    Syphilis is an infectious disease caused by Treponema pallidum that presents clinically in different ways. Over recent years, an upsurge of new cases of syphilis has been reported, often in combination with human immunodeficiency virus infection. The clinical picture is changing because of the widespread use of antibiotics, and psychiatric manifestations may be the main reason why patients seek medical help. In most cases, treatment with penicillin and psychotropic medication is effective. Electroconvulsive therapy (ECT) is rarely used for the psychiatric manifestations of neurosyphilis: we identified only 19 cases in the literature. We report here on a 40-year-old man newly diagnosed with neurosyphilis during hospitalization for a psychotic state with depression and also review the literature. He was treated with 2 courses of penicillin and several antipsychotics. The ECT was indicated because he failed to respond well to antipsychotic treatment and developed a high risk of dangerous behavior. A series of 8 sessions of ECT rapidly relieved the psychotic symptoms. PMID:25634568

  5. Prevalence of psychotic-like experiences in young adults with social anxiety disorder and correlation with affective dysregulation.

    PubMed

    Armando, Marco; Lin, Ashleigh; Girardi, Paolo; Righetti, Valentino; Dario, Claudia; Saba, Riccardo; Decrescenzo, Franco; Mazzone, Luigi; Vicari, Stefano; Birchwood, Maximillian; Fiori Nastro, Paolo

    2013-12-01

    Social anxiety disorder (SAD) is associated with psychotic-like experiences (PLEs) and is a frequent diagnosis in the prodromal phases of psychosis. We investigated whether psychopathological factors could discriminate which subjects with SAD are more likely to develop PLEs. A sample of 128 young adults with SAD was split into two subsamples according to the presence of clinically relevant PLEs. Correlations between PLEs and other psychopathological markers were explored. The SAD with PLEs group showed higher level of anxiety, depression, and intolerance of uncertainty (IU) compared with the SAD without PLEs group. A limitation of this study is that the cross-sectional design precluded the analysis of causality. In our sample, the presence of PLEs is related to higher levels of depression, anxiety, and IU. The current findings are consistent with hypotheses suggesting that cognitive disturbances, together with social anxiety, may result in PLEs. PMID:24284640

  6. A Population-based Longitudinal Study of Childhood Neurodevelopmental Disorders, IQ and Subsequent Risk of Psychotic Experiences in Adolescence

    PubMed Central

    Khandaker, Golam M.; Stochl, Jan; Zammit, Stanley; Lewis, Glyn; Jones, Peter B

    2014-01-01

    Background Schizophrenia has a neurodevelopmental component to its origin, and may share overlapping pathogenic mechanisms with childhood neurodevelopmental disorders (ND). Yet longitudinal studies of psychotic outcomes among individuals with ND are limited. We report a population-based prospective study of six common childhood ND, subsequent neurocognitive performance and the risk of psychotic experiences (PEs) in early adolescence. Methods PEs were assessed by semi-structured interviews at age 13 years. IQ and working memory were measured between ages 9 and 11 years. The presence of six neurodevelopmental disorders (autism spectrum, dyslexia, dyspraxia, dysgraphia, dysorthographia, dyscalculia) was determined from parent-completed questionnaire at age 9 years. Linear regression calculated mean difference in cognitive scores between those with and without ND. The association between ND and PEs was expressed as odds ratio (OR); effects of cognitive deficits were examined. Potential confounders included age, gender, father’s social class, ethnicity and maternal education. Results Out of 8,220 children, 487 (5.9%) were reported to have ND at age 9 years. Children with, compared with those without ND performed worse on all cognitive measures; adjusted mean difference in total IQ 6.84 (95% CI 5.00- 8.69). The association between total IQ and ND was linear (p<0.0001). The risk of PEs was higher in those with, compared with those without ND; adjusted OR for definite PEs 1.76 (95% CI 1.11- 2.79). IQ (but not working memory) deficit partly explained this association. Conclusion Higher risk of PEs in early adolescence among individuals with childhood ND is consistent with the neurodevelopmental hypothesis of schizophrenia. PMID:25066026

  7. Prescription patterns of psychotropic medications for the treatment of psychotic disorders in the largest mental health institutions of Uganda.

    PubMed

    Rukat, Annika; Musisi, Seggane; Ströhle, Andreas; Mundt, Adrian P

    2014-10-01

    The study describes prescription patterns of psychotropic medications for patients treated for psychosis in psychiatric hospitals of Uganda. A cross-sectional quantitative survey of age, sex, diagnoses, and psychotropic medication of 682 psychiatric inpatients of the 2 national referral hospitals in Uganda was conducted on 1 day in March 2012. The percentage of patients treated with the same substance within the diagnostic categories schizophrenia, bipolar affective disorder, unspecified psychosis, and depressive disorder was calculated. Close to 90% of the patients with conditions diagnosed with any psychotic disorder were treated with first-generation antipsychotic drugs (eg, chlorpromazine, haloperidol, trifluoperazine, and depot fluphenazine). Carbamazepine in combination with first-generation antipsychotics was prescribed frequently (45%) for the treatment of bipolar affective disorder. The use of second-generation antipsychotics, lithium, and valproic acid was exceptional. Patients with depression usually received a combination (63%) of first-generation antipsychotics and antidepressants (fluoxetine or amitriptyline). Benzodiazepines were only infrequently used for patients diagnosed with psychoses. First-generation antipsychotics, antidepressants, and carbamazepine were the most frequently used medications for treatment of psychosis in Uganda. Although lithium and valproic acid were on the essential drug list in Uganda, their use was still infrequent. There is a need to ensure the practical availability of the drugs listed on the essential drug list and to support the implementation of their use in clinical practice. PMID:24943390

  8. Impairments of working memory in schizophrenia and bipolar disorder: the effect of history of psychotic symptoms and different aspects of cognitive task demands

    PubMed Central

    Frydecka, Dorota; Eissa, Abeer M.; Hewedi, Doaa H.; Ali, Manal; Drapała, Jarosław; Misiak, Błażej; Kłosińska, Ewa; Phillips, Joseph R.; Moustafa, Ahmed A.

    2014-01-01

    Comparisons of cognitive impairments between schizophrenia (SZ) and bipolar disorder (BPD) have produced mixed results. We applied different working memory (WM) measures (Digit Span Forward and Backward, Short-delay and Long-delay CPT-AX, N-back) to patients with SZ (n = 23), psychotic BPD (n = 19) and non-psychotic BPD (n = 24), as well as to healthy controls (HC) (n = 18) in order to compare the level of WM impairments across the groups. With respect to the less demanding WM measures (Digit Span Forward and Backward, Short-delay CPT-AX), there were no between group differences in cognitive performance; however, with respect to the more demanding WM measures (Long-delay CPT-AX, N-back), we observed that the groups with psychosis (SZ, psychotic BPD) did not differ from one another, but performed poorer than the group without a history of psychosis (non-psychotic BPD). A history of psychotic symptoms may influence cognitive performance with respect to WM delay and load effects as measured by Long-delay CPT-AX and N-back tests, respectively. We observed a positive correlation of WM performance with antipsychotic treatment and a negative correlation with depressive symptoms in BPD and with negative symptoms in SZ subgroup. Our study suggests that WM dysfunctions are more closely related to a history of psychosis than to the diagnostic categories of SZ and BPD described by psychiatric classification systems. PMID:25506320

  9. Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis

    PubMed Central

    Vancampfort, Davy; Stubbs, Brendon; Mitchell, Alex J; De Hert, Marc; Wampers, Martien; Ward, Philip B; Rosenbaum, Simon; Correll, Christoph U

    2015-01-01

    Metabolic syndrome (MetS) and its components are highly predictive of cardiovascular diseases. The primary aim of this systematic review and meta-analysis was to assess the prevalence of MetS and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder, comparing subjects with different disorders and taking into account demographic variables and psychotropic medication use. The secondary aim was to compare the MetS prevalence in persons with any of the selected disorders versus matched general population controls. The pooled MetS prevalence in people with severe mental illness was 32.6% (95% CI: 30.8%-34.4%; N = 198; n = 52,678). Relative risk meta-analyses established that there was no significant difference in MetS prevalence in studies directly comparing schizophrenia versus bipolar disorder, and in those directly comparing bipolar disorder versus major depressive disorder. Only two studies directly compared people with schizophrenia and major depressive disorder, precluding meta-analytic calculations. Older age and a higher body mass index were significant moderators in the final demographic regression model (z = −3.6, p = 0.0003, r2 = 0.19). People treated with all individual antipsychotic medications had a significantly (p<0.001) higher MetS risk compared to antipsychotic-naïve participants. MetS risk was significantly higher with clozapine and olanzapine (except vs. clozapine) than other antipsychotics, and significantly lower with aripiprazole than other antipsychotics (except vs. amisulpride). Compared with matched general population controls, people with severe mental illness had a significantly increased risk for MetS (RR = 1.58; 95% CI: 1.35-1.86; p<0.001) and all its components, except for hypertension (p = 0.07). These data suggest that the risk for MetS is similarly elevated in the diagnostic subgroups of severe mental illness. Routine screening and

  10. Risk of metabolic syndrome and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder: a systematic review and meta-analysis.

    PubMed

    Vancampfort, Davy; Stubbs, Brendon; Mitchell, Alex J; De Hert, Marc; Wampers, Martien; Ward, Philip B; Rosenbaum, Simon; Correll, Christoph U

    2015-10-01

    Metabolic syndrome (MetS) and its components are highly predictive of cardiovascular diseases. The primary aim of this systematic review and meta-analysis was to assess the prevalence of MetS and its components in people with schizophrenia and related psychotic disorders, bipolar disorder and major depressive disorder, comparing subjects with different disorders and taking into account demographic variables and psychotropic medication use. The secondary aim was to compare the MetS prevalence in persons with any of the selected disorders versus matched general population controls. The pooled MetS prevalence in people with severe mental illness was 32.6% (95% CI: 30.8%-34.4%; N = 198; n = 52,678). Relative risk meta-analyses established that there was no significant difference in MetS prevalence in studies directly comparing schizophrenia versus bipolar disorder, and in those directly comparing bipolar disorder versus major depressive disorder. Only two studies directly compared people with schizophrenia and major depressive disorder, precluding meta-analytic calculations. Older age and a higher body mass index were significant moderators in the final demographic regression model (z = -3.6, p = 0.0003, r(2)  = 0.19). People treated with all individual antipsychotic medications had a significantly (p<0.001) higher MetS risk compared to antipsychotic-naïve participants. MetS risk was significantly higher with clozapine and olanzapine (except vs. clozapine) than other antipsychotics, and significantly lower with aripiprazole than other antipsychotics (except vs. amisulpride). Compared with matched general population controls, people with severe mental illness had a significantly increased risk for MetS (RR = 1.58; 95% CI: 1.35-1.86; p<0.001) and all its components, except for hypertension (p = 0.07). These data suggest that the risk for MetS is similarly elevated in the diagnostic subgroups of severe mental illness. Routine screening and

  11. [Communicated insanity, folie a deux and shared psychotic disorder. Different concepts and a case from Mallorca].

    PubMed

    Arenz, D; Stippel, A

    1999-06-01

    Following an earlier description of the psychopathological conceptions of "communicated insanity" we focus on a remarkable difference concerning the development of the historical terminology. The current operationalized definition is oriented at the originally French conception of the "folie à deux" which includes an adoption of certain delusional ideas by an intimate other. Compared with that, in the German psychopathological tradition those cases were also included in the conception of the "induziertes Irresein", in which the shocking experience of another's psychosis may cause a psychotic illness of somebody else. In modern psychiatric terminology this kind of "induction" is rather disregarded. We report a case of an induced psychosis in two women and give particular attention to the German psychopathological tradition because of still existing clinical relevance. PMID:10399044

  12. The Impact of Substance Abuse on Osteoporosis Screening and Risk of Osteoporosis in Women with Psychotic Disorders

    PubMed Central

    Kelly, Deanna L.; Myers, Carol S.; Abrams, Michael T.; Feldman, Stephanie; Park, Junyong; McMahon, Robert P.; Shim, Joo-Cheol

    2013-01-01

    Osteoporosis is a major public health concern. Substance abuse and psychosis may be risk factors, however frequency of screening and disease risk in women with psychotic disorders and substance use disorder (SUD) remains unknown. Methods This study examined rates (FY 2005) of osteoporosis screening and disease risk in Medicaid enrolled women aged 50 to 64 (N=18,953). Four diagnostic groups were characterized: 1) Psychosis; 2) SUD; 3) Major mood disorder and 4) Controls. The interaction of psychosis and SUD on screening and disease prevalence of osteoporosis was tested. Results The prevalence of osteoporosis across the entire population was 6.7%. Four percent of those without an osteoporosis diagnosis received osteoporosis screening with no notable differences between psychosis and controls. Those with SUD, however, had a significant reduction in screening compared to controls (OR=0.61, 95% CI 0.40–0.91, p=0.016). Women with a major mood disorder were more likely to have osteoporosis in their administrative record (OR=1.32, 95% CI=1.03–1.70, p=0.028) compared to controls. Those who were dually diagnosed (SUD and psychosis) in the oldest ages (55–64 years) had a markedly higher prevalence of osteoporosis compared to controls (OR=6.4 CI 1.51–27.6, p=0.012), whereas this interaction (SUD and psychosis) was not significant in the entire population over age 49. Conclusions Osteoporosis screening in the Medicaid population is significantly lower for women with SUD, after adjusting for age, race and Medicaid enrollment category. The prevalence of osteoporosis appears markedly elevated in those with major mood disorders and those over age 55 dually diagnosed with schizophrenia and SUD. PMID:20533029

  13. Cognitive function in euthymic bipolar disorder (BP I) patients with a history of psychotic symptoms vs. schizophrenia.

    PubMed

    Nenadic, Igor; Langbein, Kerstin; Dietzek, Maren; Forberg, Anne; Smesny, Stefan; Sauer, Heinrich

    2015-11-30

    Patients with bipolar disorder show cognitive deficits including executive function, which appear to be related to social functioning and outcome. However, subgroups within the spectrum as well as psychopathological features, current mood state/euthymia and disease stage might be confounding factors. We analysed data tests from the Wechsler Intelligence Scale (WIE), verbal fluency (COWA) and trail making tests (TMT-A and TMT-B) obtained in a selected subgroup of currently bipolar I disorder patients, who were currently euthymic and had a history of psychotic symptoms, and compared them to patients with schizophrenia (in remission) and healthy controls, all matched for age, gender, and handedness. Schizophrenia patients showed more severe cognitive impairment, including digit symbol and arithmetic tests, as well as TMT-B (compared to healthy controls), but bipolar patients had stronger impairment on the letter number sequencing test, an indicator of working memory and processing speed. There were no group effects on most verbal fluency tasks (except impairment of schizophrenia patients on one subscale of category fluency). Within the limitations of the study design, our results suggest that even in subgroups of presumably more severely impaired bipolar patients, some cognitive dimensions might achieve remission, possibly related to considerable state effects at testing. PMID:26319738

  14. Multivariate analysis reveals genetic associations of the resting default mode network in psychotic bipolar disorder and schizophrenia

    PubMed Central

    Meda, Shashwath A.; Ruaño, Gualberto; Windemuth, Andreas; O’Neil, Kasey; Berwise, Clifton; Dunn, Sabra M.; Boccaccio, Leah E.; Narayanan, Balaji; Kocherla, Mohan; Sprooten, Emma; Keshavan, Matcheri S.; Tamminga, Carol A.; Sweeney, John A.; Clementz, Brett A.; Calhoun, Vince D.; Pearlson, Godfrey D.

    2014-01-01

    The brain’s default mode network (DMN) is highly heritable and is compromised in a variety of psychiatric disorders. However, genetic control over the DMN in schizophrenia (SZ) and psychotic bipolar disorder (PBP) is largely unknown. Study subjects (n = 1,305) underwent a resting-state functional MRI scan and were analyzed by a two-stage approach. The initial analysis used independent component analysis (ICA) in 324 healthy controls, 296 SZ probands, 300 PBP probands, 179 unaffected first-degree relatives of SZ probands (SZREL), and 206 unaffected first-degree relatives of PBP probands to identify DMNs and to test their biomarker and/or endophenotype status. A subset of controls and probands (n = 549) then was subjected to a parallel ICA (para-ICA) to identify imaging–genetic relationships. ICA identified three DMNs. Hypo-connectivity was observed in both patient groups in all DMNs. Similar patterns observed in SZREL were restricted to only one network. DMN connectivity also correlated with several symptom measures. Para-ICA identified five sub-DMNs that were significantly associated with five different genetic networks. Several top-ranking SNPs across these networks belonged to previously identified, well-known psychosis/mood disorder genes. Global enrichment analyses revealed processes including NMDA-related long-term potentiation, PKA, immune response signaling, axon guidance, and synaptogenesis that significantly influenced DMN modulation in psychoses. In summary, we observed both unique and shared impairments in functional connectivity across the SZ and PBP cohorts; these impairments were selectively familial only for SZREL. Genes regulating specific neurodevelopment/transmission processes primarily mediated DMN disconnectivity. The study thus identifies biological pathways related to a widely researched quantitative trait that might suggest novel, targeted drug treatments for these diseases. PMID:24778245

  15. Relevance of Five-Factor Model personality traits for obsessive-compulsive symptoms in patients with psychotic disorders and their un-affected siblings.

    PubMed

    Schirmbeck, Frederike; Boyette, Lindy-Lou; van der Valk, Renate; Meijer, Carin; Dingemans, Peter; Van, Rien; de Haan, Lieuwe; Kahn, René S; de Haan, Lieuwe; van Os, Jim; Wiersma, Durk; Bruggeman, Richard; Cahn, Wiepke; Meijer, Carin; Myin-Germeys, Inez

    2015-02-28

    High rates of obsessive-compulsive symptoms (OCS) in schizophrenia require pathogenic explanations. Personality traits may represent risk and resiliency factors for the development of mental disorders and their comorbidities. The aim of the present study was to explore the associations between Five-Factor Model (FFM) personality traits and the liability for OCS in patients with psychotic disorders and in their un-affected siblings. FFM traits, occurrence and severity of OCS and (subclinical) psychotic symptoms were assessed in 208 patients and in 281 siblings. Differences in FFM traits between participants with vs. without comorbid OCS were examined and the predictive value of FFM traits on group categorization was evaluated. Associations between FFM traits and OCS severity were investigated. Patients and siblings with OCS showed significantly higher Neuroticism compared to their counterparts without OCS. Neuroticism was positively associated with higher OCS severity and significantly predicted group assignment in both patients and in siblings. Patients with comorbid OCS presented with lower scores on Extraversion and Conscientiousness. Higher Neuroticism, and to a lesser degree lower Extraversion and Conscientiousness might add to the vulnerability of patients with a psychotic disorder to also develop OCS. Future prospective studies are needed to elucidate proposed personality-psychopathology interrelations and possible mediating factors. PMID:25613659

  16. Serum level of venlafaxine is associated with better memory in psychotic disorders.

    PubMed

    Steen, Nils Eiel; Aas, Monica; Simonsen, Carmen; Dieset, Ingrid; Tesli, Martin; Nerhus, Mari; Gardsjord, Erlend; Mørch, Ragni; Agartz, Ingrid; Melle, Ingrid; Vaskinn, Anja; Spigset, Olav; Andreassen, Ole A

    2015-12-01

    Cognitive impairment is a core feature of psychosis spectrum disorders. Antipsychotics have at best small positive effects on cognitive performance. There is a lack of knowledge regarding the effects of antidepressants on cognitive functioning in these disorders. In the present study cognitive performance was investigated in relation to serum levels of antidepressants in persons with bipolar disorder and schizophrenia. Serum concentrations of escitalopram, citalopram and venlafaxine plus O-desmethylvenlafaxine were measured in a total of 187 participants with bipolar disorder (N=74) or schizophrenia spectrum disorders (N=113), and analyzed in relation to neuropsychological tests performance of verbal learning, verbal memory, attention, working memory, executive functioning and processing speed. Analyses were performed using linear regression adjusting for a range of confounders. There was a significant positive association between the serum level of venlafaxine plus O-desmethylvenlafaxine and verbal memory (immediate recall: Logical Memory Test immediate recall [p=0.015], and long term delayed recall: Logical Memory Test delayed recall [p=0.011]). No significant associations were seen between citalopram or escitalopram and verbal memory. There were no significant associations between the tested antidepressants and verbal learning, attention, working memory, executive functioning, or processing speed. Venlafaxine seem to be associated with better verbal memory in bipolar disorder and schizophrenia. This suggests a possible beneficial role of certain antidepressants on cognitive dysfunction, which may have clinical implications and provide insight into underlying pathophysiology. However, the current findings should be replicated in independent samples. PMID:26516101

  17. [Pilot study on a modular outpatient treatment programme following public order placements because of endangerment in patients with psychotic disorders].

    PubMed

    Luckhaus, C; Kampka, N; Frommann, N; Dönisch-Seidel, U; Gaebel, W; Janssen, B

    2014-08-01

    Patients with psychotic disorders who were detained by public order because of endangerment, can be regarded as a population at risk of further endangerment, public order placements and a forensic course. Concepts of specific aftercare for this subgroup are lacking thus far. The present pilot study explores the feasibility of a modular therapeutic outpatient programme that is tailored to specific subgroup needs and is applied over six months. Readmission rates during the intervention period are regarded exploratively.Consecutive screening of all patients placed in general psychiatry by public order during 05 to 11/2012. Included patients received baseline measurements followed by six-month intervention. Individual utilisation of treatment modules and number of readmissions, differentiated according to legal bases were assessed.Inclusion rate: 17.4 % of all screened subjects (115) and 57 % of all potentially includable subjects, dropout rate: 15 %. Mean utilisation rate: 23.5 therapeutic contacts per 6 months. Readmission rate: 50 %, of these 60 % on voluntary legal basis.Study inclusion, mean utilisation and dropout rates attest the feasibility and acceptance of the intervention in the population under study. A preponderance of voluntary vs. compulsory readmissions to hospital during the intervention indicates that in the majority of patients a higher degree of therapeutic cooperativeness can be reached. Further study on reduction of compulsory readmissions and on avoidance of a forensic course by application of the here introduced intervention in combination with methods of risk assessment in a consecutive main project seems justified. PMID:25105433

  18. Dissociation and psychotic symptoms.

    PubMed

    Steingard, S; Frankel, F H

    1985-08-01

    The literature on hysterical or brief reactive psychosis reflects great diversity both in clinical description and theoretical formulation. The authors describe the case of a 17-year-old girl who presented with a diagnosis of bipolar affective disorder, rapid cycling type, but who, in fact, was experiencing dissociative episodes manifested as psychotic states. The patient's successful treatment with hypnosis is described, along with the clinical and theoretical implications of the case. PMID:4025593

  19. [Investigation of community support measures for patients with comorbid substance use disorder and psychotic disorder: nationwide survey of drug addiction rehabilitation centers].

    PubMed

    Ikeda, Tomohiro; Koike, Junko; Kouda, Minoru; Inamoto, Atsuko; Morota, Nobuaki

    2014-12-01

    In psychiatric care practice, patients are often seen who have difficulty with their social lives due to protracted psychiatric symptoms despite years without drug abuse. The difficulty of dealing with such cases and the lack of preparedness of the legal system leave circumstantial care as the only option. Western.countries have recently begun using the name 'concurrent disorder' as a diagnosis for patients deemed unable to recover solely through such treatment for drug addiction, signifying the presence of both a substance use disorder (SUD) and a mental health disorder. Various assessment and intervention methods are being investigated, and many studies have been reported. Based on the hypothesis that Drug Addiction Rehabilitation Center (DARC) are partly involved in supporting those with psychotic concurrent disorders (PSCD) in Japan, we conducted a survey to clarify the actual support for PSCD patients at DARC and the challenges they face. Surveys were administered to DARC-related institutions all over Japan (44 governing organizations and 66 institutions). Complete responses from 86 full-time employees and 445 DARC users were analyzed. DARC users were divided into two groups: psychiatric concurrent disorders (PSCD group, n = 178) and those without such symptoms (SUD group, n = 267), with the PSCD group accounting for 40% of the DARC users surveyed. Compared to the SUD group, the PSCD group was significantly less satisfied with their lifestyle and interpersonal relations at the DARC and a significantly higher proportion of the PSCD group requested assistance in communicating with others. When employees were presented with a hypothetical PSCD case and asked what was needed to deal with it, some responses were, "an institution that can treat both drug addiction and other mental health disorders," "a psychiatric care institution that provides 24-hour care," and "sufficient manpower and training." In the future, a treatment system must be established based on

  20. Family therapy for schizophrenia: co-occurring psychotic and substance use disorders.

    PubMed

    Gottlieb, Jennifer D; Mueser, Kim T; Glynn, Shirley M

    2012-05-01

    People with schizophrenia have a high prevalence of co-occurring substance use disorders, which is related to a worse course of psychiatric illness, more frequent relapses, and increased depression and suicide, compared with those with schizophrenia alone. The Family Intervention for Dual Diagnosis (FIDD) program, which includes psychoeducation and goal setting and focuses on building communication and problem-solving skills within the family, can aid in decreasing the stress related to having a close relationship with someone with a dual disorder. Here, the case of a young man with psychosis and marijuana dependence is examined. This article describes how the FIDD intervention helped him with his problematic substance use, as well as to build skills within his relationship for increased empathy and reduced interpersonal stress. PMID:22498950

  1. Metabotropic Glutamate 2/3 Receptors and Epigenetic Modifications in Psychotic Disorders: A Review.

    PubMed

    Matrisciano, Francesco; Panaccione, Isabella; Grayson, Danis R; Nicoletti, Ferdinando; Guidotti, Alessandro

    2016-01-01

    Schizophrenia and Bipolar Disorder are chronic psychiatric disorders, both considered as "major psychosis"; they are thought to share some pathogenetic factors involving a dysfunctional gene x environment interaction. Alterations in the glutamatergic transmission have been suggested to be involved in the pathogenesis of psychosis. Our group developed an epigenetic model of schizophrenia originated by Prenatal Restraint Stress (PRS) paradigm in mice. PRS mice developed some behavioral alterations observed in schizophrenic patients and classic animal models of schizophrenia, i.e. deficits in social interaction, locomotor activity and prepulse inhibition. They also showed specific changes in promoter DNA methylation activity of genes related to schizophrenia such as reelin, BDNF and GAD67, and altered expression and function of mGlu2/3 receptors in the frontal cortex. Interestingly, behavioral and molecular alterations were reversed by treatment with mGlu2/3 agonists. Based on these findings, we speculate that pharmacological modulation of these receptors could have a great impact on early phase treatment of psychosis together with the possibility to modulate specific epigenetic key protein involved in the development of psychosis. In this review, we will discuss in more details the specific features of the PRS mice as a suitable epigenetic model for major psychosis. We will then focus on key proteins of chromatin remodeling machinery as potential target for new pharmacological treatment through the activation of metabotropic glutamate receptors. PMID:26813121

  2. Metabotropic Glutamate 2/3 Receptors and Epigenetic Modifications in Psychotic Disorders: A Review

    PubMed Central

    Matrisciano, Francesco; Panaccione, Isabella; Grayson, Danis R.; Nicoletti, Ferdinando; Guidotti, Alessandro

    2016-01-01

    Schizophrenia and Bipolar Disorder are chronic psychiatric disorders, both considered as “major psychosis”; they are thought to share some pathogenetic factors involving a dysfunctional gene x environment interaction. Alterations in the glutamatergic transmission have been suggested to be involved in the pathogenesis of psychosis. Our group developed an epigenetic model of schizophrenia originated by Prenatal Restraint Stress (PRS) paradigm in mice. PRS mice developed some behavioral alterations observed in schizophrenic patients and classic animal models of schizophrenia, i.e. deficits in social interaction, locomotor activity and prepulse inhibition. They also showed specific changes in promoter DNA methylation activity of genes related to schizophrenia such as reelin, BDNF and GAD67, and altered expression and function of mGlu2/3 receptors in the frontal cortex. Interestingly, behavioral and molecular alterations were reversed by treatment with mGlu2/3 agonists. Based on these findings, we speculate that pharmacological modulation of these receptors could have a great impact on early phase treatment of psychosis together with the possibility to modulate specific epigenetic key protein involved in the development of psychosis. In this review, we will discuss in more details the specific features of the PRS mice as a suitable epigenetic model for major psychosis. We will then focus on key proteins of chromatin remodeling machinery as potential target for new pharmacological treatment through the activation of metabotropic glutamate receptors. PMID:26813121

  3. Impact of Different Childhood Adversities on 1-Year Outcomes of Psychotic Disorder in the Genetics and Psychosis Study.

    PubMed

    Trotta, Antonella; Murray, Robin M; David, Anthony S; Kolliakou, Anna; O'Connor, Jennifer; Di Forti, Marta; Dazzan, Paola; Mondelli, Valeria; Morgan, Craig; Fisher, Helen L

    2016-03-01

    While the role of childhood adversity in increasing the risk of psychosis has been extensively investigated, it is not clear what the impact of early adverse experiences is on the outcomes of psychotic disorders. Therefore, we investigated associations between childhood adversity and 1-year outcomes in 285 first-presentation psychosis patients. Exposure to childhood adversity prior to 17 years of age was assessed using the Childhood Experience of Care and Abuse Questionnaire. Data on illness course, symptom remission, length of psychiatric hospitalization, compliance with medication, employment, and relationship status were extracted from clinical records for the year following first contact with mental health services for psychosis. Seventy-one percent of patients reported exposure to at least 1 type of childhood adversity (physical abuse, sexual abuse, parental separation, parental death, disrupted family arrangements, or being taken into care). No robust associations were found between childhood adversity and illness course or remission. However, childhood physical abuse was associated with almost 3-fold increased odds of not being in a relationship at 1-year follow-up compared to patients who did not report such adverse experiences. There was also evidence of a significant association between parental separation in childhood and longer admissions to psychiatric wards during 1-year follow-up and 2-fold increased odds of noncompliance with medication compared to those not separated from their parents. Therefore, our findings suggest that there may be some specificity in the impact of childhood adversity on service use and social functioning among psychosis patients over the first year following presentation to mental health services. PMID:26373540

  4. Impact of Different Childhood Adversities on 1-Year Outcomes of Psychotic Disorder in the Genetics and Psychosis Study

    PubMed Central

    Trotta, Antonella; Murray, Robin M.; David, Anthony S.; Kolliakou, Anna; O’Connor, Jennifer; Di Forti, Marta; Dazzan, Paola; Mondelli, Valeria; Morgan, Craig; Fisher, Helen L.

    2016-01-01

    While the role of childhood adversity in increasing the risk of psychosis has been extensively investigated, it is not clear what the impact of early adverse experiences is on the outcomes of psychotic disorders. Therefore, we investigated associations between childhood adversity and 1-year outcomes in 285 first-presentation psychosis patients. Exposure to childhood adversity prior to 17 years of age was assessed using the Childhood Experience of Care and Abuse Questionnaire. Data on illness course, symptom remission, length of psychiatric hospitalization, compliance with medication, employment, and relationship status were extracted from clinical records for the year following first contact with mental health services for psychosis. Seventy-one percent of patients reported exposure to at least 1 type of childhood adversity (physical abuse, sexual abuse, parental separation, parental death, disrupted family arrangements, or being taken into care). No robust associations were found between childhood adversity and illness course or remission. However, childhood physical abuse was associated with almost 3-fold increased odds of not being in a relationship at 1-year follow-up compared to patients who did not report such adverse experiences. There was also evidence of a significant association between parental separation in childhood and longer admissions to psychiatric wards during 1-year follow-up and 2-fold increased odds of noncompliance with medication compared to those not separated from their parents. Therefore, our findings suggest that there may be some specificity in the impact of childhood adversity on service use and social functioning among psychosis patients over the first year following presentation to mental health services. PMID:26373540

  5. A multicentre study on the efficacy and safety of individualized dosage of haloperidol (Haldol) in refractory chronic psychotics.

    PubMed

    Nicodeme, A; Vranckx-Haenen, J; Wouters, J

    1977-01-01

    This study was carried out on 38 chronic refractory psychotic patients who received partial multimodal treatment with individually adapted doses of Haldol. The study was based on: --Howard's experiences: more than half of his chronic psychotic patients were able to leave the State Hospital because of the multimodal treatment with high individualized doses of Haldol; -Paquay and Tanghe's experiences: one-fourth to more than one-half of their chronic refractory patients showed remarkable improvement with a partial multimodal treatment. This study shows that improvement is obtained in more than 2 out of 3 cases, thus proving that the best results are obtained when an adequate selection of the patients is made. As side-effects, above all, the extrapyramidal symptoms are possible. However, their frequency and intensity are not higher than those provoked by other incisive neuroleptics or conventional doses of Haldol. Special attention should be given to any pseudodepression or neurovegetative reactions. The individualization of the doses should be carefully done. PMID:337756

  6. Case report of comorbid alcohol-induced psychotic disorder and Madelung’s disease

    PubMed Central

    SUN, Zhenxiao; LI, Huanjun

    2014-01-01

    Summary Madelung’s disease, also known as benign symmetric lipomatosis (BSL), multiple symmetric lipomatosis (MSL), fatty neck syndrome or Launois-Bensaude syndrome, is a rare disease characterized by the presence of multiple, symmetric, loose adipose tissues distributed around the neck, occipitalis, shoulder, back or chest. The fat masses are non-encapsulated and therefore can move freely between adjacent areas. This disease is most commonly seen among middle-aged Caucasian men of Mediterranean origins; it is rarely reported in Asia. Among individuals with Madelung’s syndrome, 60 to 90% have a history of chronic alcohol abuse. We report a case of a 51-year-old Chinese man with a history of alcohol use disorder who had fat masses in his neck which gradually enlarged over a period of three years. Based on the case history and the results of physical examination, neck CT and other routine tests, he was diagnosed with Madelung’s syndrome. PMID:25114492

  7. Genetic and environmental determinants of violence risk in psychotic disorders: a multivariate quantitative genetic study of 1.8 million Swedish twins and siblings

    PubMed Central

    Sariaslan, A; Larsson, H; Fazel, S

    2016-01-01

    Patients diagnosed with psychotic disorders (for example, schizophrenia and bipolar disorder) have elevated risks of committing violent acts, particularly if they are comorbid with substance misuse. Despite recent insights from quantitative and molecular genetic studies demonstrating considerable pleiotropy in the genetic architecture of these phenotypes, there is currently a lack of large-scale studies that have specifically examined the aetiological links between psychotic disorders and violence. Using a sample of all Swedish individuals born between 1958 and 1989 (n=3 332 101), we identified a total of 923 259 twin-sibling pairs. Patients were identified using the National Patient Register using validated algorithms based on International Classification of Diseases (ICD) 8–10. Univariate quantitative genetic models revealed that all phenotypes (schizophrenia, bipolar disorder, substance misuse, and violent crime) were highly heritable (h2=53–71%). Multivariate models further revealed that schizophrenia was a stronger predictor of violence (r=0.32; 95% confidence interval: 0.30–0.33) than bipolar disorder (r=0.23; 0.21–0.25), and large proportions (51–67%) of these phenotypic correlations were explained by genetic factors shared between each disorder, substance misuse, and violence. Importantly, we found that genetic influences that were unrelated to substance misuse explained approximately a fifth (21% 20–22%) of the correlation with violent criminality in bipolar disorder but none of the same correlation in schizophrenia (Pbipolar disorder<0.001; Pschizophrenia=0.55). These findings highlight the problems of not disentangling common and unique sources of covariance across genetically similar phenotypes as the latter sources may include aetiologically important clues. Clinically, these findings underline the importance of assessing risk of different phenotypes together and integrating interventions for psychiatric disorders, substance misuse, and

  8. Genetic and environmental determinants of violence risk in psychotic disorders: a multivariate quantitative genetic study of 1.8 million Swedish twins and siblings.

    PubMed

    Sariaslan, A; Larsson, H; Fazel, S

    2016-09-01

    Patients diagnosed with psychotic disorders (for example, schizophrenia and bipolar disorder) have elevated risks of committing violent acts, particularly if they are comorbid with substance misuse. Despite recent insights from quantitative and molecular genetic studies demonstrating considerable pleiotropy in the genetic architecture of these phenotypes, there is currently a lack of large-scale studies that have specifically examined the aetiological links between psychotic disorders and violence. Using a sample of all Swedish individuals born between 1958 and 1989 (n=3 332 101), we identified a total of 923 259 twin-sibling pairs. Patients were identified using the National Patient Register using validated algorithms based on International Classification of Diseases (ICD) 8-10. Univariate quantitative genetic models revealed that all phenotypes (schizophrenia, bipolar disorder, substance misuse, and violent crime) were highly heritable (h(2)=53-71%). Multivariate models further revealed that schizophrenia was a stronger predictor of violence (r=0.32; 95% confidence interval: 0.30-0.33) than bipolar disorder (r=0.23; 0.21-0.25), and large proportions (51-67%) of these phenotypic correlations were explained by genetic factors shared between each disorder, substance misuse, and violence. Importantly, we found that genetic influences that were unrelated to substance misuse explained approximately a fifth (21%; 20-22%) of the correlation with violent criminality in bipolar disorder but none of the same correlation in schizophrenia (Pbipolar disorder<0.001; Pschizophrenia=0.55). These findings highlight the problems of not disentangling common and unique sources of covariance across genetically similar phenotypes as the latter sources may include aetiologically important clues. Clinically, these findings underline the importance of assessing risk of different phenotypes together and integrating interventions for psychiatric disorders, substance misuse, and violence

  9. Region-of-Interest-Based Analysis With Application of Cortical Thickness Variation of Left Planum Temporale in Schizophrenia and Psychotic Bipolar Disorder

    PubMed Central

    Qiu, Anqi; Vaillant, Marc; Barta, Patrick; Ratnanather, J. Tilak; Miller, Michael I.

    2010-01-01

    In neuroimaging studies, spatial normalization and multivariate testing are central problems in characterizing group variation of functions (e.g., cortical thickness, curvature, functional response) in an atlas coordinate system across clinical populations. We present a region-of-interest (ROI)-based analysis framework for detecting such a group variation. This framework includes two main techniques: ROI-based registration via large deformation diffeomorphic metric surface mapping and a multivariate testing using a Gaussian random field (GRF) model on the cortical surface constructed by the eigenfunctions of the Laplace–Beltrami operator. We compared our GRF statistical model with a pointwise hypothesis testing approach, whose P-value is corrected using false discovery rate or random field theory at several smoothness scales. As an illustration, we applied this framework to a clinical study of the cortical thickness of the left planum temporale (PT) in subjects with psychotic bipolar disorder, schizophrenia, and healthy comparison controls. Our results show that the anterior portion of the left PT is thinner in the psychotic bipolar and schizophrenic groups than in the healthy control group, and the posterior portion of the left PT shows the reversal finding. Moreover, there may be a greater thickness variation in the left PT in psychotic bipolar patients when compared with that in schizophrenic patients. PMID:17705219

  10. Children with Reading Disorders--I. Efficacy of Reading Remediation.

    ERIC Educational Resources Information Center

    Gittelman, Rachel; Feingold, Ingrid

    1983-01-01

    The efficacy of reading remediation, which emphasizes phonic decoding, was examined in 61 children (ages 7 through 13 years) with pure reading disorders. Comparisons between pre- and post intervention data clearly support the efficacy of remediation. (MP)

  11. Genetic association study between the detected risk variants based upon type II diabetes GWAS and psychotic disorders in the Japanese population.

    PubMed

    Kajio, Yusuke; Kondo, Kenji; Saito, Takeo; Iwayama, Yoshimi; Aleksic, Branko; Yamada, Kazuo; Toyota, Tomoko; Hattori, Eiji; Ujike, Hiroshi; Inada, Toshiya; Kunugi, Hiroshi; Kato, Tadafumi; Yoshikawa, Takeo; Ozaki, Norio; Ikeda, Masashi; Iwata, Nakao

    2014-01-01

    Several epidemiological and genetic studies have suggested that the risk of type II diabetes (T2D) is likely to overlap with the susceptibility to psychotic disorders such as schizophrenia (SCZ) and bipolar disorder (BD). In this study, we aimed to examine the association of single-nucleotide polymorphisms (SNPs) detected in previous T2D genome-wide association studies (GWAS) with SCZ, BD and psychosis (SCZ plus BD). A total of 37 SNPs were selected from the literature. A two-stage analysis was conducted using a first set of screening samples (total N=3037) and a second set of replication samples (N=4950). None of the SNPs showed a significant association to the screening samples after correction for multiple testing. To avoid type II error, we genotyped the top three SNPs in BCL11A, HMG20A and HNF4A showing associations with any of the phenotypes (Puncorrected <0.01) using independent samples to replicate the nominal associations. However, we were unable to find any significant associations based on the screening results (Puncorrected>0.05). Our findings did not support the shared genetic risk between T2D and psychotic disorders in the Japanese population. However, further replication using a larger sample size is required. PMID:24196380

  12. Primary care-based educational interventions to decrease risk factors for metabolic syndrome for adults with major psychotic and/or affective disorders: a systematic review

    PubMed Central

    2013-01-01

    Background Individuals with major psychotic and/or affective disorders are at increased risk for developing metabolic syndrome due to lifestyle- and treatment-related factors. Numerous pharmacological and non-pharmacological interventions have been tested in inpatient and outpatient mental health settings to decrease these risk factors. This review focuses on primary care-based non-pharmacological (educational or behavioral) interventions to decrease metabolic syndrome risk factors in adults with major psychotic and/or affective disorders. Methods The authors conducted database searches of PsychINFO, MEDLINE and the Cochrane Database of Systematic Reviews, as well as manual searches and gray literature searches to identify included studies. Results The authors were unable to identify any studies meeting a priori inclusion criteria because there were no primary care-based studies. Conclusions This review was unable to demonstrate effectiveness of educational interventions in primary care. Interventions to decrease metabolic syndrome risk have been demonstrated to be effective in mental health and other outpatient settings. The prevalence of mental illness in primary care settings warrants similar interventions to improve health outcomes for this population. PMID:24369749

  13. Efficacy of Cognitive-Behavioral Therapy for Comorbid Panic Disorder with Agoraphobia and Generalized Anxiety Disorder

    ERIC Educational Resources Information Center

    Labrecque, Joane; Marchand, Andre; Dugas, Michel J.; Letarte, Andree

    2007-01-01

    The goal of this study was to evaluate the efficacy of cognitive-behavioral therapy for comorbid panic disorder with agoraphobia (PDA) and generalized anxiety disorder (GAD) by combining treatment strategies for both disorders. A single-case, multiple-baseline design across participants was used. Three participants with primary PDA and secondary…

  14. Paranoid personality disorder

    MedlinePlus

    ... have a full-blown psychotic disorder, such as schizophrenia . Causes Causes of paranoid personality disorder are unknown. ... common in families with psychotic disorders, such as schizophrenia and delusional disorder. This suggests genes may be ...

  15. Correlates of transient versus persistent psychotic symptoms among dependent methamphetamine users.

    PubMed

    McKetin, Rebecca; Gardner, Jonathon; Baker, Amanda L; Dawe, Sharon; Ali, Robert; Voce, Alexandra; Leach, Liana S; Lubman, Dan I

    2016-04-30

    This study examined correlates of transient versus persistent psychotic symptoms among people dependent on methamphetamine. A longitudinal prospective cohort study of dependent methamphetamine users who did not meet DSM-IV criteria for lifetime schizophrenia or mania. Four non-contiguous one-month observation periods were used to identify participants who had a) no psychotic symptoms, (n=110); (b) psychotic symptoms only when using methamphetamine (transient psychotic symptoms, n=85); and, (c) psychotic symptoms both when using methamphetamine and when abstaining from methamphetamine (persistent psychotic symptoms, n=37). Psychotic symptoms were defined as a score of 4 or greater on any of the Brief Psychiatric Rating Scale items of suspiciousness, hallucinations or unusual thought content. Relative no psychotic symptoms, both transient and persistent psychotic symptoms were associated with childhood conduct disorder and comorbid anxiety disorders. Earlier onset methamphetamine use and being male were more specifically related to transient psychotic symptoms, while a family history of a primary psychotic disorder and comorbid major depression were specifically related to persistent psychotic symptoms. We conclude that there are overlapping but also distinct clinical correlates of transient versus persistent psychotic symptoms, suggesting potentially heterogeneous etiological pathways underpinning the psychotic phenomena seen amongst people who use methamphetamine. PMID:27086229

  16. Remote “Hovering” with Individuals with Psychotic Disorders and Substance Use: Feasibility, Engagement, and Therapeutic Alliance with a Text-Messaging Mobile Interventionist

    PubMed Central

    Ben-Zeev, Dror; Kaiser, Susan M.; Krzos, Izabela

    2014-01-01

    Objective People with serious mental illnesses and substance abuse problems (i.e., dual diagnosis) constitute a particularly challenging and costly clinical group. This study evaluated the feasibility and acceptability of a novel model of care in which a mobile interventionist used mobile phone text messaging to remotely monitor and provide daily support to individuals with psychotic disorders and substance use. Methods Seventeen participants with dual diagnosis were enrolled in a twelve-week single-arm trial. A clinical social worker served as the mobile interventionist and sent daily text-messages to participants’ privately-owned mobile phones to assess their medication adherence and clinical status. The mobile interventionist provided text-message feedback and support, and suggested various coping strategies flexibly, in response to participants’ replies to prompts. At the end of the trial, participants completed a usability and satisfaction measure and two self-rated measures of therapeutic alliance with their clinicians. In one version, participants rated their relationship with their mobile interventionist; in the second version, they rated their relationship with their community-based treatment team. Results Participants received an average of 139 text messages (SD = 37.5) each from the mobile interventionist over the twelve-week trial. On average, participants responded to 87% of the mobile interventionist’s messages that required a reply. Over 90% of participants thought the intervention was useful and rewarding, and that it helped them be more effective and productive in their lives. Participants’ assessments of their relationship with the mobile interventionist were positive. Paired sample t-test found the therapeutic alliance ratings participants provided for their mobile interventionist were significantly higher than those provided for their community-based treatment team clinicians who they met with regularly. Conclusions Our findings suggest

  17. First-Episode Service for Psychotic Disorders in the U.S. Public Sector: A Pragmatic Randomized Controlled Trial

    PubMed Central

    Srihari, Vinod H; Tek, Cenk; Kucukgoncu, Suat; Phutane, Vivek; Breitborde, Nicholas J. K.; Pollard, Jessica; Ozkan, Banu; Saksa, John; Walsh, Barbara C; Wood, Scott W

    2015-01-01

    Objective This study seeks to determine the effectiveness of a comprehensive first-episode service (the clinic for Specialized Treatment Early in Psychosis, STEP) based in an urban U.S. community mental health center, compared to treatment as usual. Methods This pragmatic randomized controlled trial enrolled 120 ‘first-episode psychosis’ patients within 5 years of illness onset and 12 weeks of antipsychotic exposure. Referrals were mostly from area inpatient psychiatric units and enrollees were randomly allocated to STEP or referral to routine care (TU). Main outcomes included hospital utilization (primary), ability to work, attend age-appropriate schooling or actively seek these opportunities (‘vocational engagement’), and general functioning. Analysis was by modified intent to treat (excluding only 3 who withdrew consent) for hospitalization and completers for other outcomes. Results After one year, STEP effected reductions on all measures of inpatient utilization vs. usual treatment: not psychiatrically hospitalized (77% vs. 56%, RR 1.38, 95% confidence interval (CI) 1.08–1.58); mean hospitalizations (0.33±0.70 vs. 0.68±0.92, p=0.02) and mean bed days (5.34±13.53 vs. 11.51±15.04, p=0.05). For every 5 patients allocated in STEP vs. usual treatment, one additional patient avoided psychiatric hospitalization over the first year (NNT = 5, CI 2.7–26.5). STEP also delivered better vocational engagement (91.7% vs. 66.7%, RR 1.40, 95% CI 1.18–1.48) and salutary trends in measures of global functioning. Conclusions This trial demonstrates the feasibility and effectiveness of a U.S. public sector model of early intervention for psychotic illnesses. Such services can also support translational research and are a relevant model for other serious mental illnesses. Trial registration www.ClinicalTrials.gov: NCT00309452. PMID:25639994

  18. Comparison of disability and quality of life measures in patients with long-term psychotic disorders and patients with multiple sclerosis: an application of the WHO Disability Assessment Schedule II and WHO Quality of Life-BREF.

    PubMed

    Chopra, Prem; Herrman, Helen; Kennedy, Genevieve

    2008-06-01

    The aim of this article is to compare the applications of the WHO Disability Assessment Schedule II (WHODAS II) and WHO Quality of Life-BREF (WHOQOL-BREF) in the assessment of patients with psychotic disorders and multiple sclerosis, and to assess the feasibility and usefulness of such universal measures in the psychiatric as well as physical rehabilitation setting. Twenty patients with psychotic disorders from St Vincent's Mental Health Service and 20 patients from the Medical Rehabilitation Ward of St Vincent's Hospital were assessed. The WHODAS II and WHOQOL-BREF were administered to each patient to obtain their perception of the impact of their disability and their health-related quality of life (HRQoL). The WHODAS II and WHOQOL-BREF interviews were meaningful as they highlighted aspects of patients' disabilities as well as issues that led to impairment in HRQoL. The WHODAS II and WHOQOL-BREF total scores were higher overall for patients with multiple sclerosis, reflecting, in particular, the physical impact of this condition. Patients with psychotic disorders generally did not report difficulty in self-care. Both patients with multiple sclerosis and patients with psychotic disorders reported similar levels of difficulty in the domain of participation in society. Universal measures of disability and HRQoL are feasible for use in patients with long-term physical and psychiatric illnesses. Similarities in the disability profiles of patients in the two groups reflect the consequences of the long-term conditions under investigation. Both groups of patients reported similar levels of social disability, confirming that barriers to participation in society affect all patients with disabling conditions. PMID:18467928

  19. An open trial of a new acceptance-based behavioral treatment for major depression with psychotic features.

    PubMed

    Gaudiano, Brandon A; Nowlan, Kathryn; Brown, Lily A; Epstein-Lubow, Gary; Miller, Ivan W

    2013-05-01

    Research suggests that cognitive and behavioral therapies produce significant benefits over medications alone in the treatment of severe, nonpsychotic major depression or primary psychotic disorders such as schizophrenia. However, previous research has not demonstrated the efficacy of psychotherapy for major depression with psychotic features. In this initial treatment development study, we conducted an open trial of a new behavioral intervention that combines elements of behavioral activation and acceptance and commitment therapy for depression and psychosis. Fourteen patients with major depressive disorder with psychotic features were provided with up to 6 months of Acceptance-Based Depression and Psychosis Therapy (ADAPT) in combination with pharmacotherapy. Patients reported a high degree of treatment credibility and acceptability. Results showed that patients achieved clinically significant and sustained improvements through posttreatment follow-up in depressive and psychotic symptoms, as well as psychosocial functioning. In addition, the processes targeted by the intervention (e.g., acceptance, mindfulness, values) improved significantly over the course of treatment, and changes in processes were correlated with changes in symptoms. Results suggest that ADAPT combined with pharmacotherapy is a promising treatment approach for psychotic depression that should be tested in a future randomized trial. PMID:23223385

  20. An examination of associations between the inability to taste phenylthiocarbamide (PTC) and clinical characteristics and trait markers in first-episode, nonaffective psychotic disorders

    PubMed Central

    Compton, Michael T.; Ionescu, Dawn Flosnik; Broussard, Beth; Cristofaro, Sarah L.; Johnson, Stephanie; Haggard, Patrick J.; Potts, Amy A.; Wan, Claire Ramsay; Walker, Elaine F.

    2013-01-01

    Research findings are mixed as to whether or not the inability to taste phenylthiocarbamide (PTC) might represent an endophenotypic trait marker for schizophrenia. We hypothesized associations between PTC-tasting status and select clinical characteristics and trait markers in patients with psychotic disorders that, if present, would provide support for the inability to taste PTC as a trait marker. In a first-episode psychosis sample (n=93), we measured PTC tasting, family history of psychosis, age at onset of prodrome and psychosis, severity of positive and negative symptoms, global impairment in functioning, neurological soft signs, and four neurocognitive domains (verbal learning/memory, visual learning/memory, verbal working memory, and spatial working memory). Associations between PTC-non-tasting and clinical/neurocognitive variables were examined with χ2 tests and independent samples t tests. Among participants, 67.7% tasted PTC in comparison to a strip of control paper, and 25.8% were non-tasters. Tasters and non-tasters did not statistically significantly differ with respect to family history, age at onset, severity of symptoms, neurological soft signs, or the four neurocognitive domains. In conjunction with other findings, it is unlikely that PTC-non-tasting is a trait marker of schizophrenia, though a conclusive study is warranted. PMID:23598058

  1. Intervention Efficacy and Intensity for Children with Speech Sound Disorder

    ERIC Educational Resources Information Center

    Allen, Melissa M.

    2013-01-01

    Purpose: Clinicians do not have an evidence base they can use to recommend optimum intervention intensity for preschool children who present with speech sound disorder (SSD). This study examined the effect of dose frequency on phonological performance and the efficacy of the multiple oppositions approach. Method: Fifty-four preschool children with…

  2. [Clinical significance of psychotic-like symptoms in youth].

    PubMed

    Lindgren, Maija; Therman, Sebastian; Granö, Niklas

    2016-01-01

    Symptoms of the psychotic type are relatively common in young persons, but seldom result in the development of an actual psychotic disorder. Psychotic-like symptoms in the young are, however, associated with more severe psychiatric symptoms and a less favorable prognosis, whereby their identification is important in psychiatric treatment. A symptom-oriented approach is important in the treatment: instead of the possible risk of psychosis, focus will be on the actual situation, taking the total symptom picture and the person's life situation into consideration. Cognitive psychotherapy is the recommended first-line treatment for psychotic-like symptoms. PMID:27132292

  3. Efficacy and tolerability of aripiprazole augmentation in sertraline-resistant patients with borderline personality disorder.

    PubMed

    Bellino, Silvio; Paradiso, Erika; Bogetto, Filippo

    2008-11-30

    Information is available on aripiprazole as a treatment for borderline personality disorder (BPD), but no data have yet been presented concerning the use of this drug as an adjunctive treatment for drug-resistant BPD patients. This study investigates aripiprazole augmentation of ongoing sertraline therapy in drug-resistant BPD patients. Twenty-one outpatients with a DSM-IV-TR diagnosis of BPD who did not respond to sertraline, 100-200 mg/day for 12 weeks, were treated for 12 weeks with the addition of aripiprazole, 10-15 mg/day. Patients were assessed at baseline, week 4, and week 12 with the Clinical Global Impression Scale - Severity item (CGI-S), the Brief Psychiatric Rating Scale (BPRS), the Hamilton scales for depression and anxiety (HAM-D, HAM-A), the Social Occupational Functioning Assessment Scale (SOFAS) for social functioning, the Borderline Personality Disorder Severity Index (BPDSI), and the Barratt Impulsiveness Scale (BIS-11). Adverse effects were evaluated using the Dosage Record and Treatment Emergent Symptom Scale (DOTES). Sixteen patients completed the study. Five patients (23.8%) dropped out due to anxiety/insomnia or non-compliance. Nine patients (56.3%) were responders. Analysis of variance revealed significant changes in the following measures: CGI-S, BPRS, BPDSI total score, BPDSI "impulsivity" and "dissociation/paranoid ideation" items, and BIS-11. Adverse effects were mild headache, insomnia, and anxiety. Aripiprazole is an efficacious and well-tolerated add-on treatment for sertraline-resistant BPD patients. It acts on impulsive and psychotic-like symptoms. PMID:18848360

  4. Client Perceptions of the Mental Health Engagement Network: A Secondary Analysis of an Intervention Using Smartphones and Desktop Devices for Individuals Experiencing Mood or Psychotic Disorders in Canada

    PubMed Central

    Donelle, Lorie; Ethridge, Paige; Warner, Laura

    2015-01-01

    Background The use of innovative technologies in mental health care has the potential to improve system efficiency, enhance quality of care, and increase patient engagement. The Mental Health Engagement Network (MHEN) project developed, delivered, and evaluated an interactive Web-based personal health record, the Lawson SMART Record (LSR), to assist mental health clients in managing their care and connecting with their care providers. This paper presents a secondary analysis of data collected in the MHEN project regarding clients’ perceptions of technology and the use of these technologies in their care. Objective We aimed to answer six questions: (1) What is the level of comfort with technology within a sample of individuals experiencing mood or psychotic disorders? (2) How easy to use and helpful are the MHEN technologies from the perspective of individuals experiencing a mental illness? (3) Are there differences in how helpful or useful individuals find the smartphone compared to the LSR? (4) Are there specific functions of MHEN technologies (eg, reminders for medications or appointments) that are more valued than others? (5) What are the other ways that individuals are using MHEN technologies in their daily lives? (6) How likely are individuals to be able to retain and maintain their smartphone? Methods Mental health clients aged 18-80 (N=400) and diagnosed with a mood or psychotic disorder were provided with a smartphone (iPhone 4S) and participating care providers (n=52) were provided with a tablet (iPad) in order to access and engage with the LSR. A delayed implementation design with mixed methods was used. Survey and interview data were collected over the course of 18 months through semistructured interviews conducted by experienced research assistants every 6 months post-implementation of the intervention. Paired t tests were used to determine differences between 6 and 12-month data for perceptions of the MHEN technologies. A paired t test was used to

  5. A Web-Based Tool to Support Shared Decision Making for People With a Psychotic Disorder: Randomized Controlled Trial and Process Evaluation

    PubMed Central

    Emerencia, Ando C; Boonstra, Nynke; Wunderink, Lex; de Jonge, Peter; Sytema, Sjoerd

    2013-01-01

    Background Mental health policy makers encourage the development of electronic decision aids to increase patient participation in medical decision making. Evidence is needed to determine whether these decision aids are helpful in clinical practice and whether they lead to increased patient involvement and better outcomes. Objective This study reports the outcome of a randomized controlled trial and process evaluation of a Web-based intervention to facilitate shared decision making for people with psychotic disorders. Methods The study was carried out in a Dutch mental health institution. Patients were recruited from 2 outpatient teams for patients with psychosis (N=250). Patients in the intervention condition (n=124) were provided an account to access a Web-based information and decision tool aimed to support patients in acquiring an overview of their needs and appropriate treatment options provided by their mental health care organization. Patients were given the opportunity to use the Web-based tool either on their own (at their home computer or at a computer of the service) or with the support of an assistant. Patients in the control group received care as usual (n=126). Half of the patients in the sample were patients experiencing a first episode of psychosis; the other half were patients with a chronic psychosis. Primary outcome was patient-perceived involvement in medical decision making, measured with the Combined Outcome Measure for Risk Communication and Treatment Decision-making Effectiveness (COMRADE). Process evaluation consisted of questionnaire-based surveys, open interviews, and researcher observation. Results In all, 73 patients completed the follow-up measurement and were included in the final analysis (response rate 29.2%). More than one-third (48/124, 38.7%) of the patients who were provided access to the Web-based decision aid used it, and most used its full functionality. No differences were found between the intervention and control conditions

  6. Antipsychotic drugs attenuate aberrant DNA methylation of DTNBP1 (dysbindin) promoter in saliva and post-mortem brain of patients with schizophrenia and Psychotic bipolar disorder.

    PubMed

    Abdolmaleky, Hamid M; Pajouhanfar, Sara; Faghankhani, Masoomeh; Joghataei, Mohammad Taghi; Mostafavi, Ashraf; Thiagalingam, Sam

    2015-12-01

    Due to the lack of genetic association between individual genes and schizophrenia (SCZ) pathogenesis, the current consensus is to consider both genetic and epigenetic alterations. Here, we report the examination of DNA methylation status of DTNBP1 promoter region, one of the most credible candidate genes affected in SCZ, assayed in saliva and post-mortem brain samples. The Illumina DNA methylation profiling and bisulfite sequencing of representative samples were used to identify methylation status of the DTNBP1 promoter region. Quantitative methylation specific PCR (qMSP) was employed to assess methylation of DTNBP1 promoter CpGs flanking a SP1 binding site in the saliva of SCZ patients, their first-degree relatives and control subjects (30, 15, and 30/group, respectively) as well as in post-mortem brains of patients with SCZ and bipolar disorder (BD) versus controls (35/group). qRT-PCR was used to assess DTNBP1 expression. We found DNA hypermethylation of DTNBP1 promoter in the saliva of SCZ patients (∼12.5%, P = 0.036), particularly in drug-naïve patients (∼20%, P = 0.011), and a trend toward hypermethylation in their first-degree relatives (P = 0.085) versus controls. Analysis of post-mortem brain samples revealed an inverse correlation between DTNBP1 methylation and expression, and normalization of this epigenetic change by classic antipsychotic drugs. Additionally, BD patients with psychotic depression exhibited higher degree of methylation versus other BD patients (∼80%, P = 0.025). DTNBP1 promoter DNA methylation may become a key element in a panel of biomarkers for diagnosis, prevention, or therapy in SCZ and at risk individuals pending confirmatory studies with larger sample sizes to attain a higher degree of significance. PMID:26285059

  7. Future marginalisation and mortality in young Swedish men with non-psychotic psychiatric disorders and the resilience effect of cognitive ability: a prospective, population-based study

    PubMed Central

    Löve, J; Hensing, G; Söderberg, M; Torén, K; Waern, M; Åberg, M

    2016-01-01

    Objective Large-scale studies examining future trajectories of marginalisation and health in adolescents with mental illness are scarce. The aim of this study was to examine if non-psychotic psychiatric disorders (NPDs) were associated with future indicators of marginalisation and mortality. We also aimed to determine whether these associations might be mediated by education level and attenuated by high cognitive ability. Design This is a prospective cohort study with baseline data from the Swedish Conscription register. Setting The study was carried out in Sweden from 1969 to 2005. Participants All of the participants were 18-year-old men at mandatory conscription in Sweden between 1969 and 2005 (n=1 609 690). Measures NPDs were clinically diagnosed at conscription. Cognitive ability was measured by a standardised IQ test at conscription. National register data covered information on welfare support, long-term unemployment, disability pension (DP) and mortality over a period of 1–36 years. Results NPD at the age of 18 years was a predictor of future welfare support, OR 3.73 (95% CI 3.65 to 3.80); long-term unemployment, OR 1.97 (95% CI 1.94 to 2.01); DP, HR 2.95 (95% CI 2.89 to 3.02); and mortality, HR 2.45 (2.33–2.52). The adjusted models suggested that these associations were not confounded by fathers’ educational level, cognitive ability had only a minor attenuating effect on most associations and the mediating effect of own educational level was small. Conclusions The present study underlines a higher prevalence of future adversities in young men experiencing NPDs at the age of 18 years. It also indicates that higher cognitive ability may work as a potential resilience factor against future marginalisation and mortality. PMID:27515748

  8. The affective reactivity of psychotic speech: The role of internal source monitoring in explaining increased thought disorder under emotional challenge.

    PubMed

    de Sousa, Paulo; Sellwood, William; Spray, Amy; Bentall, Richard P

    2016-04-01

    Thought disorder (TD) has been shown to vary in relation to negative affect. Here we examine the role internal source monitoring (iSM, i.e. ability to discriminate between inner speech and verbalized speech) in TD and whether changes in iSM performance are implicated in the affective reactivity effect (deterioration of TD when participants are asked to talk about emotionally-laden topics). Eighty patients diagnosed with schizophrenia-spectrum disorder and thirty healthy controls received interviews that promoted personal disclosure (emotionally salient) and interviews on everyday topics (non-salient) on separate days. During the interviews, participants were tested on iSM, self-reported affect and immediate auditory recall. Patients had more TD, poorer ability to discriminate between inner and verbalized speech, poorer immediate auditory recall and reported more negative affect than controls. Both groups displayed more TD and negative affect in salient interviews but only patients showed poorer performance on iSM. Immediate auditory recall did not change significantly across affective conditions. In patients, the relationship between self-reported negative affect and TD was mediated by deterioration in the ability to discriminate between inner speech and speech that was directed to others and socially shared (performance on the iSM) in both interviews. Furthermore, deterioration in patients' performance on iSM across conditions significantly predicted deterioration in TD across the interviews (affective reactivity of speech). Poor iSM is significantly associated with TD. Negative affect, leading to further impaired iSM, leads to increased TD in patients with psychosis. Avenues for future research as well as clinical implications of these findings are discussed. PMID:26851142

  9. [Treating a psychotic syndrome in 2007].

    PubMed

    Olié, Jean-Pierre

    2008-01-01

    It is well established that we have to consider 3 patterns of psychotic symptoms: positive (hallucinations, delusion...), negative (affective flatness, autism...) symptoms and disorganization (ambivalence, incoherence...). In the past, ECT (electroconvulsivotherapy) was the first effective treatment in psychiatry. Conventionnal neuroleptics have been determinant in the significant evolution of care to psychotic patients. ECT use is now better defined in terms of practise and indications. Assessment of new antipsychotic medications is mainly focused on efficacy on positive symptoms. Atypical antipsychotics brought improvement in treating psychotic syndromes: they are better tolerated and more effective on the whole spectrum of psychotic syndromes including emotional symptoms than conventional neuroleptics. Atypical antipsychotics have raised questions about metabolic and cardiac risks. Compliance remains a cause of failure of many antipsychotic treatments. Treating a psychotic syndrome requires complementary strategies to medications: conditions of assistance and rehabilitation, choice of psychotherapy. Research program are currently orientated towards: - identification of prepsychotic symptoms and endophenotypes which can be treatment targets; - assessment of putative therapeutical means such a brain stimulation. PMID:18718208

  10. The association of white matter volume in psychotic disorders with genotypic variation in NRG1, MOG and CNP: a voxel-based analysis in affected individuals and their unaffected relatives.

    PubMed

    Cannon, D M; Walshe, M; Dempster, E; Collier, D A; Marshall, N; Bramon, E; Murray, R M; McDonald, C

    2012-01-01

    We investigated the role of variation in putative psychosis genes coding for elements of the white matter system by examining the contribution of genotypic variation in three single-nucleotide polymorphisms (SNPs) neuregulin 1 (NRG1) SNP8NRG221533, myelin oligodendrocytes glycoprotein (MOG) rs2857766 and CNP (rs2070106) and one haplotype HAP(ICE) (deCODE) to white matter volume in patients with psychotic disorder and their unaffected relatives. Structural magnetic resonance imaging and blood samples for genotyping were collected on 189 participants including patients with schizophrenia (SZ) or bipolar I disorder (BDI), unaffected first-degree relatives of these patients and healthy volunteers. The association of genotypic variation with white matter volume was assessed using voxel-based morphometry in SPM5. The NRG1 SNP and the HAP(ICE) haplotype were associated with abnormal white matter volume in the BDI group in the fornix, cingulum and parahippocampal gyrus circuit. In SZ the NRG1 SNP risk allele was associated with lower white matter volume in the uncinate fasciculus (UF), right inferior longitudinal fasciculus and the anterior limb of the internal capsule. Healthy G-homozygotes of the MOG SNP had greater white matter volume in areas of the brainstem and cerebellum; this relationship was absent in those with a psychotic disorder and the unaffected relatives groups. The CNP SNP did not contribute to white matter volume variation in the diagnostic groups studied. Variation in the genes coding for structural and protective components of myelin are implicated in abnormal white matter volume in the emotion circuitry of the cingulum, fornix, parahippocampal gyrus and UF in psychotic disorders. PMID:23032943

  11. Comparison of Visuospatial and Verbal Abilities in First Psychotic Episode of Schizophrenia Spectrum Disorder: Impact on Global Functioning and Quality of Life

    PubMed Central

    Rodriguez, Mabel; Spaniel, Filip; Konradova, Lucie; Sedlakova, Katerina; Dvorska, Karolina; Prajsova, Jitka; Kratochvilova, Zuzana; Levcik, David; Vlcek, Kamil; Fajnerova, Iveta

    2015-01-01

    Objectives: Deficit in visuospatial functions can influence both simple and complex daily life activities. Despite the fact that visuospatial deficit was reported in schizophrenia, research on visuospatial functions as an independent entity is limited. Our study aims to elucidate the impact of visuospatial deficit in comparison with verbal deficit on global functioning and quality of life in the first psychotic episode of schizophrenia spectrum disorder (FES). The significance of clinical symptoms and antipsychotic medication was also studied. Methods: Thirty-six FES patients and a matched group of healthy controls (HC group) were assessed with a neuropsychological battery focused on visuospatial (VIS) and verbal (VERB) functions. Using multiple regression analysis, we evaluated the cumulative effect of VERB and VIS functions, psychiatric symptoms (PANSS) and antipsychotic medication on global functioning (GAF) and quality of life (WHOQOL-BREF) in the FES group. Results: The FES group demonstrated significant impairment both in VIS and VERB cognitive abilities compared to the HC group. Antipsychotic medication did not significantly affect either VIS or VERB functioning. PANSS was not related to cognitive functioning, apart from the Trail Making Test B. In the FES group, the GAF score was significantly affected by the severity of positive symptoms and VERB functioning, explaining together 60% of GAF variability. The severity of negative and positive symptoms affected only the Physical health domain of WHOQOL-BREF. The degree of VERB deficit was associated with both Physical and Psychological health. Although we did not find any relation between VIS functioning, GAF, and WHOQOL-BREF, a paradoxical finding emerged in the Environment quality domain, where a worse quality of the environment was associated with better VIS functioning. Conclusions: Our results suggest that the deficit in VIS functions is an integral part of cognitive deficit in schizophrenia spectrum

  12. Ziprasidone Augmentation of Escitalopram for Major Depressive Disorder: Efficacy Results from a Randomized, Double-Blind, Placebo-Controlled Study

    PubMed Central

    Papakostas, George I.; Fava, Maurizio; Baer, Lee; Swee, Michaela B.; Jaeger, Adrienne; Bobo, William V.; Shelton, Richard C.

    2016-01-01

    Objective To test the efficacy of adjunctive ziprasidone in adults with non-psychotic unipolar major depression experiencing persistent symptoms following 8 weeks of open-label escitalopram. Method This was a multi-center, parallel randomized, double-blind, placebo-controlled trial conducted at three academic medical centers in the United States. The participant pool consisted of 139 outpatients with persistent symptoms of major depressive disorder following an 8-week open label trial of escitalopram (phase 1). Subjects were randomized (1:1, n=139) to adjunctive ziprasidone (escitalopram+ziprasidone, n=71) or adjunctive placebo (escitalopram+placebo, n=68), with 8 weekly follow-up assessments. Primary outcome was defined by clinical response according to the 17-item Hamilton Depression Rating Scale (HAMD-17) and determined by a 50% or greater reduction in scale scores. The Hamilton Anxiety Rating scale (HAM-A) and Visual Analogue Scale for Pain were defined a priori as key secondary outcome measures. Results Rates of clinical response (35.2% vs. 20.5%, p=0.04) and mean improvement in HAMD-17 total scores (−6.4 ± 6.4 vs. −3.3 ± 6.2, p=0.04) were significantly greater for the escitalopram+ziprasidone group. Several secondary measures of antidepressant efficacy were also in favor of adjunctive ziprasidone. Escitalopram+ziprasidone also resulted in significantly greater improvement in HAM-A, but not Visual Analogue Scale for Pain scores. Ten (14%) patients discontinued escitalopram+ziprasidone due to intolerance versus none for escitalopram+placebo (p<0.01 versus placebo). Conclusions Adjunctive ziprasidone, when added to escitalopram, demonstrated antidepressant efficacy in adult patients with major depressive disorder experiencing persistent symptoms following 8 weeks of open-label escitalopram. PMID:26085041

  13. Early-Life Stress Affects Stress-Related Prefrontal Dopamine Activity in Healthy Adults, but Not in Individuals with Psychotic Disorder

    PubMed Central

    Kasanova, Zuzana; Hernaus, Dennis; Vaessen, Thomas; van Amelsvoort, Thérèse; Winz, Oliver; Heinzel, Alexander; Pruessner, Jens; Mottaghy, Felix M.

    2016-01-01

    Early life stress may have a lasting impact on the developmental programming of the dopamine (DA) system implicated in psychosis. Early adversity could promote resilience by calibrating the prefrontal stress-regulatory dopaminergic neurotransmission to improve the individual’s fit with the predicted stressful environment. Aberrant reactivity to such match between proximal and distal environments may, however, enhance psychosis disease risk. We explored the combined effects of childhood adversity and adult stress by exposing 12 unmedicated individuals with a diagnosis of non-affective psychotic disorder (NAPD) and 12 healthy controls (HC) to psychosocial stress during an [18F]fallypride positron emission tomography. Childhood trauma divided into early (ages 0–11 years) and late (12–18 years) was assessed retrospectively using a questionnaire. A significant group x childhood trauma interaction on the spatial extent of stress-related [18F]fallypride displacement was observed in the mPFC for early (b = -8.45, t(1,23) = -3.35, p = .004) and late childhood trauma (b = -7.86, t(1,23) = -2.48, p = .023). In healthy individuals, the spatial extent of mPFC DA activity under acute psychosocial stress was positively associated with the severity of early (b = 7.23, t(11) = 3.06, p = .016) as well as late childhood trauma (b = -7.86, t(1,23) = -2.48, p = .023). Additionally, a trend-level main effect of early childhood trauma on subjective stress response emerged within this group (b = -.7, t(11) = -2, p = .07), where higher early trauma correlated with lower subjective stress response to the task. In the NAPD group, childhood trauma was not associated with the spatial extent of the tracer displacement in mPFC (b = -1.22, t(11) = -0.67), nor was there a main effect of trauma on the subjective perception of stress within this group (b = .004, t(11) = .01, p = .99). These findings reveal a potential mechanism of neuroadaptation of prefrontal DA transmission to early life

  14. Early-Life Stress Affects Stress-Related Prefrontal Dopamine Activity in Healthy Adults, but Not in Individuals with Psychotic Disorder.

    PubMed

    Kasanova, Zuzana; Hernaus, Dennis; Vaessen, Thomas; van Amelsvoort, Thérèse; Winz, Oliver; Heinzel, Alexander; Pruessner, Jens; Mottaghy, Felix M; Collip, Dina; Myin-Germeys, Inez

    2016-01-01

    Early life stress may have a lasting impact on the developmental programming of the dopamine (DA) system implicated in psychosis. Early adversity could promote resilience by calibrating the prefrontal stress-regulatory dopaminergic neurotransmission to improve the individual's fit with the predicted stressful environment. Aberrant reactivity to such match between proximal and distal environments may, however, enhance psychosis disease risk. We explored the combined effects of childhood adversity and adult stress by exposing 12 unmedicated individuals with a diagnosis of non-affective psychotic disorder (NAPD) and 12 healthy controls (HC) to psychosocial stress during an [18F]fallypride positron emission tomography. Childhood trauma divided into early (ages 0-11 years) and late (12-18 years) was assessed retrospectively using a questionnaire. A significant group x childhood trauma interaction on the spatial extent of stress-related [18F]fallypride displacement was observed in the mPFC for early (b = -8.45, t(1,23) = -3.35, p = .004) and late childhood trauma (b = -7.86, t(1,23) = -2.48, p = .023). In healthy individuals, the spatial extent of mPFC DA activity under acute psychosocial stress was positively associated with the severity of early (b = 7.23, t(11) = 3.06, p = .016) as well as late childhood trauma (b = -7.86, t(1,23) = -2.48, p = .023). Additionally, a trend-level main effect of early childhood trauma on subjective stress response emerged within this group (b = -.7, t(11) = -2, p = .07), where higher early trauma correlated with lower subjective stress response to the task. In the NAPD group, childhood trauma was not associated with the spatial extent of the tracer displacement in mPFC (b = -1.22, t(11) = -0.67), nor was there a main effect of trauma on the subjective perception of stress within this group (b = .004, t(11) = .01, p = .99). These findings reveal a potential mechanism of neuroadaptation of prefrontal DA transmission to early life stress

  15. Children with reading disorders--I. Efficacy of reading remediation.

    PubMed

    Gittelman, R; Feingold, I

    1983-04-01

    The efficacy of reading remediation, which emphasized phonetic decoding, was investigated in children with pure reading disorders, controlling for the influence on non-specific treatment effects. Sixty-one children were randomly assigned to receive instruction in reading or in other subjects for four months. Children were re-evaluated immediately after, and two and eight months after, the cessation of the intervention. At the end of treatment, the children who had received reading remediation obtained significantly higher scores than the controls on all reading tests. Some of the treatment advantages were maintained beyond the treatment period. Results clearly support the efficacy of reading remediation which emphasizes phonetic skills. The study does not address itself to whether this treatment method differs from other remedial interventions. PMID:6841505

  16. Dissociative detachment relates to psychotic symptoms and personality decompensation.

    PubMed

    Allen, J G; Coyne, L; Console, D A

    1997-01-01

    Previous studies have addressed the prominence of psychotic symptoms in conjunction with multiple personality disorder (now dissociative identity disorder). The present study examines the relation between psychotic symptoms and a more pervasive form of dissociative disturbance, namely dissociative detachment. Two hundred sixty-six women in inpatient treatment for severe trauma-related disorders completed the Dissociative Experiences Scale (DES), and 102 of these patients also completed the Millon Clinical Multiaxial Inventory (MCMI-III). A factor analysis of the DES yielded two dimensions of dissociative detachment: detachment from one's own actions and detachment from the self and the environment. Each of these DES dimensions relates strongly to the thought disorder and schizotypal personality disorder scales of the MCMI-III. We propose that severe dissociative detachment, by virtue of loosening the moorings in inner and outer reality, is conducive to psychotic symptoms and personality decompensation. PMID:9406738

  17. Comparative efficacy and tolerability of drug treatments for bipolar disorder.

    PubMed

    Strakowski, S M; DelBello, M P; Adler, C M

    2001-01-01

    Lithium has been the backbone of treatment for bipolar disorder for several decades, although recent advances have identified a number of other medications that have efficacy in treating various phases of the illness. These include the antiepileptic drugs valproate semisodium (divalproex sodium) and carbamazepine and some new antiepileptic drugs (e.g. lamotrigine and topiramate), and the atypical antipsychotics (e.g. olanzapine, clozapine and risperidone). Conventional antipsychotics continue to be used frequently in bipolar disorder, although they may be somewhat less effective than other treatments. Otherwise, to date, none of these treatments have been shown to be consistently more effective than any other, so that drug adverse effects and tolerability often dictate which agents are used in an individual patient. Drugs commonly used for the treatment of bipolar disorder are generally tolerated by most patients in large samples. However, the unique adverse effect signature of a drug will often suggest that it will be less tolerable in some patients than in others. Identifying a specific treatment for a specific patient requires a careful individualised assessment of the risk of adverse effects for that patient's unique circumstances. PMID:11580309

  18. Open-Label, Prospective Trial of Olanzapine in Adolescents with Subaverage Intelligence and Disruptive Behavioral Disorders

    ERIC Educational Resources Information Center

    Handen, Benjamin L.; Hardan, Antonio Y.

    2006-01-01

    Objective: Olanzapine, an atypical antipsychotic, has been shown to be efficacious for treatment of psychotic and mood disorders in adults. This prospective, open-label study was conducted to examine the safety and usefulness of olanzapine in treating disruptive behavior disorders in adolescents with subaverage intelligence. Method: Sixteen…

  19. Abstinence Self-Efficacy and Abstinence 1 Year After Substance Use Disorder Treatment

    ERIC Educational Resources Information Center

    Ilgen, Mark; McKellar, John; Tiet, Quyen

    2005-01-01

    To better understand the relationship between abstinence self-efficacy and treatment outcomes in substance use disorder patients, experts in the field need more information about the levels of abstinence self-efficacy most predictive of treatment outcomes. Participants (N = 2,967) from 15 residential substance use disorder treatment programs were…

  20. Psychotic-like Experiences and Substance Use in College Students.

    PubMed

    Fonseca-Pedrero, Eduardo; Ortuño-Sierra, Javier; Paino, Mercedes; Muñiz, José

    2016-01-01

    Psychotic disorders, as well as psychotic-like experiences and substance use, have been found to be associated. The main goal of the present study was to analyse the relationship between psychoticlike experiences and substance use in college students. The simple comprised a total of 660 participants (M = 20.3 years, SD = 2.6). The results showed that 96% of the sample reported some delusional experience, while 20.3% reported at least one positive psychotic-like experience. Some substance use was reported by 41.1% of the sample, differing in terms of gender. Substance users reported more psychoticlike experiences than non-users, especially in the positive dimension. Also, alcohol consumption predicted in most cases extreme scores on measures of delusional ideation and psychotic experiences. The association between these two variables showed a differentiated pattern, with a stronger relationship between substance use and cognitive-perceptual psychotic-like experiences. To some extent, these findings support the dimensional models of the psychosis phenotype and contribute a better understanding of the links between psychoticlike experiences and substance use in young adults. Future studies should further explore the role of different risk factors for psychotic disorders and include models of the gene-environment interaction. PMID:27399223

  1. Mental Disorders

    MedlinePlus

    ... disorders Psychotic disorders, including schizophrenia There are many causes of mental disorders. Your genes and family history ... Biological factors can also be part of the cause. A traumatic brain injury can lead to a ...

  2. Eros and psychotic despair.

    PubMed

    Genovese, Celestino

    2006-10-01

    The author suggests that Freud's theory of sexuality is not adequate to explain the issue of psychosis. The sexual drive presupposes construction of the unity of the subject, whereas psychosis takes root in a period of life when the ego is not yet integrated. In a neurotic subject, suffering is always an expression of sexuality. By contrast, in a psychotic person, even aspects explicitly connected with sexuality represent an attempt to escape from despair. In the former it is a question of pleasure, and in the latter of relief In light of these considerations, the author discusses the problem of erotomania. PMID:17094373

  3. Moving from Efficacy to Effectiveness in Cognitive Behavioral Therapy for Psychosis: A Randomized Clinical Practice Trial

    ERIC Educational Resources Information Center

    Lincoln, Tania M.; Ziegler, Michael; Mehl, Stephanie; Kesting, Marie-Luise; Lullmann, Eva; Westermann, Stefan; Rief, Winfried

    2012-01-01

    Objective: Randomized controlled trials have attested the efficacy of cognitive behavioral therapy (CBT) in reducing psychotic symptoms. Now, studies are needed to investigate its effectiveness in routine clinical practice settings. Method: Eighty patients with schizophrenia spectrum disorders who were seeking outpatient treatment were randomized…

  4. Primary headaches interfere with the efficacy of temporomandibular disorders management

    PubMed Central

    PORPORATTI, André Luís; COSTA, Yuri Martins; CONTI, Paulo César Rodrigues; BONJARDIM, Leonardo Rigoldi; CALDERON, Patrícia dos Santos

    2015-01-01

    OBJECTIVES: This cross-sectional study aimed to evaluate the influence of Primary Headache (PH) on efficacy of a Temporomandibular Disorders (TMD) conservative therapy and its association with the presence of self-reported parafunctional habits. SAMPLE AND METHODS: Sample was composed of 400 medical records, divided into four groups: I) Muscular TMD (n=64); II) Muscular TMD+PH (n=48); III) Muscular TMD+Articular TMD (n=173); IV) Muscular TMD+Articular TMD+PH (n=115). All groups had undergone a TMD therapy for three months with a stabilization appliance and counseling for habits and behavioral changes, with no specific headache management. Current pain intensity and existence or not of self-reported bruxism were assessed. Repeated measures ANOVA and Chi-Square test followed by Odds were used for statistical analysis, with a significance level of 5%. RESULTS: results of this study showed that: (1) A conservative therapy with stabilization appliance and counseling for habits and behavioral changes was effective in the TMD pain relief; (2) Groups with an additional diagnosis of PH had worsened the pain improvement significantly; and (3) no association between the presence of self-reported bruxism and PH was found. CONCLUSIONS: this study could elucidate the important effect that headache may have on the TMD management. PMID:25004051

  5. Efficacy of treatments for anxiety disorders: a meta-analysis.

    PubMed

    Bandelow, Borwin; Reitt, Markus; Röver, Christian; Michaelis, Sophie; Görlich, Yvonne; Wedekind, Dirk

    2015-07-01

    To our knowledge, no previous meta-analysis has attempted to compare the efficacy of pharmacological, psychological and combined treatments for the three main anxiety disorders (panic disorder, generalized anxiety disorder and social phobia). Pre-post and treated versus control effect sizes (ES) were calculated for all evaluable randomized-controlled studies (n = 234), involving 37,333 patients. Medications were associated with a significantly higher average pre-post ES [Cohen's d = 2.02 (1.90-2.15); 28,051 patients] than psychotherapies [1.22 (1.14-1.30); 6992 patients; P < 0.0001]. ES were 2.25 for serotonin-noradrenaline reuptake inhibitors (n = 23 study arms), 2.15 for benzodiazepines (n = 42), 2.09 for selective serotonin reuptake inhibitors (n = 62) and 1.83 for tricyclic antidepressants (n = 15). ES for psychotherapies were mindfulness therapies, 1.56 (n = 4); relaxation, 1.36 (n = 17); individual cognitive behavioural/exposure therapy (CBT), 1.30 (n = 93); group CBT, 1.22 (n = 18); psychodynamic therapy 1.17 (n = 5); therapies without face-to-face contact (e.g. Internet therapies), 1.11 (n = 34); eye movement desensitization reprocessing, 1.03 (n = 3); and interpersonal therapy 0.78 (n = 4). The ES was 2.12 (n = 16) for CBT/drug combinations. Exercise had an ES of 1.23 (n = 3). For control groups, ES were 1.29 for placebo pills (n = 111), 0.83 for psychological placebos (n = 16) and 0.20 for waitlists (n = 50). In direct comparisons with control groups, all investigated drugs, except for citalopram, opipramol and moclobemide, were significantly more effective than placebo. Individual CBT was more effective than waiting list, psychological placebo and pill placebo. When looking at the average pre-post ES, medications were more effective than psychotherapies. Pre-post ES for psychotherapies did not differ from pill placebos; this finding cannot be explained by heterogeneity, publication bias or allegiance effects. However, the decision on whether to choose

  6. Data Gathering Bias: Trait Vulnerability to Psychotic Symptoms?

    PubMed Central

    Catalan, Ana; Simons, Claudia J. P.; Bustamante, Sonia; Olazabal, Nora; Ruiz, Eduardo; Gonzalez de Artaza, Maider; Penas, Alberto; Maurottolo, Claudio; González, Andrea; van Os, Jim; Gonzalez-Torres, Miguel Angel

    2015-01-01

    Background Jumping to conclusions (JTC) is associated with psychotic disorder and psychotic symptoms. If JTC represents a trait, the rate should be (i) increased in people with elevated levels of psychosis proneness such as individuals diagnosed with borderline personality disorder (BPD), and (ii) show a degree of stability over time. Methods The JTC rate was examined in 3 groups: patients with first episode psychosis (FEP), BPD patients and controls, using the Beads Task. PANSS, SIS-R and CAPE scales were used to assess positive psychotic symptoms. Four WAIS III subtests were used to assess IQ. Results A total of 61 FEP, 26 BPD and 150 controls were evaluated. 29 FEP were revaluated after one year. 44% of FEP (OR = 8.4, 95% CI: 3.9–17.9) displayed a JTC reasoning bias versus 19% of BPD (OR = 2.5, 95% CI: 0.8–7.8) and 9% of controls. JTC was not associated with level of psychotic symptoms or specifically delusionality across the different groups. Differences between FEP and controls were independent of sex, educational level, cannabis use and IQ. After one year, 47.8% of FEP with JTC at baseline again displayed JTC. Conclusions JTC in part reflects trait vulnerability to develop disorders with expression of psychotic symptoms. PMID:26147948

  7. Efficacy and Safety of Atomoxetine in Childhood Attention-Deficit/Hyperactivity Disorder with Comorbid Oppositional Defiant Disorder

    ERIC Educational Resources Information Center

    Kaplan, S.; Heiligenstein, J.; West, S.; Busner, J.; Harder, D.; Dittmann, R.; Casat, C.; Wernicke, J. F.

    2004-01-01

    Objective: To compare the safety and efficacy of atomoxetine, a selective inhibitor of the norepinephrine transporter, versus placebo in Attention-Deficit/Hyperactivity Disorder (ADHD) patients with comorbid Oppositional Defiant Disorder (ODD). Methods: A subset analysis of 98 children from two identical, multi-site, double-blind, randomized,…

  8. Methylomic analysis of monozygotic twins discordant for childhood psychotic symptoms

    PubMed Central

    Fisher, Helen L; Murphy, Therese M; Arseneault, Louise; Caspi, Avshalom; Moffitt, Terrie E; Viana, Joana; Hannon, Eilis; Pidsley, Ruth; Burrage, Joe; Dempster, Emma L; Wong, Chloe C Y; Pariante, Carmine M; Mill, Jonathan

    2015-01-01

    Childhood psychotic symptoms are associated with increased rates of schizophrenia, other psychiatric disorders, and suicide attempts in adulthood; thus, elucidating early risk indicators is crucial to target prevention efforts. There is considerable discordance for psychotic symptoms between monozygotic twins, indicating that child-specific non-genetic factors must be involved. Epigenetic processes may constitute one of these factors and have not yet been investigated in relation to childhood psychotic symptoms. Therefore, this study explored whether differences in DNA methylation at age 10 were associated with monozygotic twin discordance for psychotic symptoms at age 12. The Environmental Risk (E-Risk) Longitudinal Twin Study cohort of 2,232 children (1,116 twin pairs) was assessed for age-12 psychotic symptoms and 24 monozygotic twin pairs discordant for symptoms were identified for methylomic comparison. Children provided buccal samples at ages 5 and 10. DNA was bisulfite modified and DNA methylation was quantified using the Infinium HumanMethylation450 array. Differentially methylated positions (DMPs) associated with psychotic symptoms were subsequently tested in post-mortem prefrontal cortex tissue from adult schizophrenia patients and age-matched controls. Site-specific DNA methylation differences were observed at age 10 between monozygotic twins discordant for age-12 psychotic symptoms. Similar DMPs were not found at age 5. The top-ranked psychosis-associated DMP (cg23933044), located in the promoter of the C5ORF42 gene, was also hypomethylated in post-mortem prefrontal cortex brain tissue from schizophrenia patients compared to unaffected controls. These data tentatively suggest that epigenetic variation in peripheral tissue is associated with childhood psychotic symptoms and may indicate susceptibility to schizophrenia and other mental health problems. PMID:26479702

  9. [Pre-psychotic states--contemporary diagnostic and therapeutic issues. Part I. Clinical identification of pre-psychotic states].

    PubMed

    Czernikiewicz, Andrzej; Szulc, Agata

    2007-01-01

    Early intervention in psychotic disorders, particularly schizophrenia, has been increasingly recognized as important by clinicians. The benefits of early intervention in schizophrenia to patients include prevention of neurobiological changes, minimization of secondary morbidity and prevention of relapse. Other benefits of prepsychotic intervention include the capacity to research the onset phase of psychosis. We would like to support in our paper a statement by Maeres: What is needed is not diagnosing the early stages of schizophrenia but the diagnosis of prepsychotic schizophrenia. We are interested in recognizing the schizophrenia 'prodrome' prospectively using to concepts: subjects 'at risk mental state' (ARMS) and subjects from 'ultra high risk' (UHR) group. For clinical reasons that involves both some clinical features of pre-psychotic states (attenuated psychotic symptoms) and some "trait factors", i.e. schizotypal personality or family predisposition factors. Recent data revealed that some characteristics of pre-psychotic states had stronger predictive value: longer symptoms duration, lower level of GAF (< 40), and presence of attenuated psychotic symptoms. The possibility of providing intervention prior to the onset of psychosis has risen from recent interest in early intervention in these pre-psychotic states. PMID:17494410

  10. [Psychotic episode due to Hashimoto's thyroiditis].

    PubMed

    Nazou, M; Parlapani, E; Nazlidou, E-I; Athanasis, P; Bozikas, V P

    2016-01-01

    Thyroid hormones are crucial in adult brain metabolic activity. As a result, abnormal thyroid gland function and in particular hypofunction, might cause principally depression and neurocognitive dysfunction. Psychosis, presented mainly with thought disorders and perceptual disturbances, is a much rarer manifestation of hypothyreoidism. A correlation between hypothyreoidism and psychosis has been described since 1888, especially in cases of advanced hypothyreoidism. A few years later (1949), Asher first added the terminology "myxedema madness" to the literature. Psychotic symptoms typically appear after the onset of physical symptoms, usually with a delay of months or years. The case of a female patient who presented a psychotic episode as a first manifestation of hypothyroidism will be described. NE, a 48 yearold female patient, was admitted for the first time to an inpatient mental health care unit due to delusions of persecution and reference, as well as auditory hallucinations that appeared a few weeks ago. After the patient admission, routine laboratory examination was conducted. In order to relieve the patient from her sense of discomfort and while awaiting laboratory results, olanzapine, 5 mg/day, was administered. Neurological examination and cranial computed tomography scan were unremarkable. Hormonal laboratory tests though revealed severe low thyroid hormone levels. Thyroid antibody testing certified Hashimoto's thyroiditis. Olanzapine was discontinued and the patient received thyroid hormone substitution, levothyroxine 75 μg/day, instead. The patient was discharged showing a significant improvement of psychotic symptoms after a 12-day hospitalization. A month later the patient was reevaluated. She had fully recovered from the psychotic episode. A year later, the patient continues to remain free from psychiatric symptoms, while thyroid hormone levels have been restored within normal range. The patient continues receiving only thyroid hormone substitution

  11. Prevalence and correlates of psychotic experiences amongst children of depressed parents.

    PubMed

    Bevan Jones, Rhys; Mars, Becky; Collishaw, Stephan; Potter, Robert; Thapar, Ajay; Craddock, Nick; Thapar, Anita; Zammit, Stanley

    2016-09-30

    Psychotic experiences in young people are substantially more common than psychotic disorders, and are associated with distress and functional impairment. Family history of depression as well as of schizophrenia increases risk for psychotic experiences, but the prevalence of such experiences and their clinical relevance in offspring of depressed parents is unknown. Our objectives were to explore i) the prevalence of psychotic experiences amongst offspring of parents with recurrent unipolar depression and ii) the relationship between psychotic experiences and other psychopathology. Data were drawn from the 'Early Prediction of Adolescent Depression' longitudinal study of high-risk offspring (aged 9-17 years at baseline) of 337 parents with recurrent depression. Three assessments were conducted over four years. Psychopathology was assessed using the Child and Adolescent Psychiatric Assessment. Seventy-eight percent of families (n=262) had complete data on psychotic experiences at each of the three time points. During the study, 8.4% (n=22; 95% CI 5.0%, 11.8%) of offspring reported psychotic experiences on at least one occasion, and these were associated with psychiatric disorder, specifically mood and disruptive disorders, and suicidal thoughts/behaviour. Psychotic experiences amongst offspring of depressed parents index a range of psychopathology. Further research is needed to examine their clinical significance and long-term consequences. PMID:27376666

  12. Efficacy of Teacher In-Service Training for Attention-Deficit/Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Jones, Heather A.; Chronis-Tuscano, Andrea

    2008-01-01

    Children with attention-deficit/hyperactivity disorder (ADHD) evidence many problems in the classroom. Teacher in-service training is routinely used to inform school professionals about a number of special topics; however, the efficacy of such in-service training for ADHD has not been established. The present study examined the efficacy of brief…

  13. Posttraumatic Stress Disorder and Community Collective Efficacy following the 2004 Florida Hurricanes

    PubMed Central

    Ursano, Robert J.; McKibben, Jodi B. A.; Reissman, Dori B.; Liu, Xian; Wang, Leming; Sampson, Robert J.; Fullerton, Carol S.

    2014-01-01

    There is a paucity of research investigating the relationship of community-level characteristics such as collective efficacy and posttraumatic stress following disasters. We examine the association of collective efficacy with probable posttraumatic stress disorder and posttraumatic stress disorder symptom severity in Florida public health workers (n = 2249) exposed to the 2004 hurricane season using a multilevel approach. Anonymous questionnaires were distributed electronically to all Florida Department of Health personnel nine months after the 2004 hurricane season. The collected data were used to assess posttraumatic stress disorder and collective efficacy measured at both the individual and zip code levels. The majority of participants were female (80.42%), and ages ranged from 20 to 78 years (median = 49 years); 73.91% were European American, 13.25% were African American, and 8.65% were Hispanic. Using multi-level analysis, our data indicate that higher community-level and individual-level collective efficacy were associated with a lower likelihood of having posttraumatic stress disorder (OR = 0.93, CI = 0.88–0.98; and OR = 0.94, CI = 0.92–0.97, respectively), even after adjusting for individual sociodemographic variables, community socioeconomic characteristic variables, individual injury/damage, and community storm damage. Higher levels of community-level collective efficacy and individual-level collective efficacy were also associated with significantly lower posttraumatic stress disorder symptom severity (b = −0.22, p<0.01; and b = −0.17, p<0.01, respectively), after adjusting for the same covariates. Lower rates of posttraumatic stress disorder are associated with communities with higher collective efficacy. Programs enhancing community collective efficacy may be an important part of prevention practices and possibly lead to a reduction in the rate of posttraumatic stress disorder post-disaster. PMID:24523900

  14. Classes of Psychotic Experiences in Kenyan Children and Adolescents

    ERIC Educational Resources Information Center

    Mamah, Daniel; Owoso, Akinkunle; Mbwayo, Anne W.; Mutiso, Victoria N.; Muriungi, Susan K.; Khasakhala, Lincoln I.; Barch, Deanna M.; Ndetei, David M.

    2013-01-01

    Psychotic-like experiences (PLEs) have been observed worldwide in both adults and children outside the context of a clinical disorder. In the current study, we investigate the prevalence and patterns of PLEs among children and adolescents in Kenya. Among 1,971 students from primary and secondary schools around Nairobi (aged 8-19), 22.1 % reported…

  15. A Follow-up Study of Early Onset Psychosis: Comparison between Outcome Diagnoses of Schizophrenia, Mood Disorders, and Personality Disorders.

    ERIC Educational Resources Information Center

    McClellan, Jon M.; And Others

    1993-01-01

    This study of 95 youths previously diagnosed with psychotic disorders found that at follow-up, 24 had a diagnosis of schizophrenia, 9 with psychotic mood disorders, 5 with personality disorders, and 1 with schizo-affective disorder. The study confirmed findings regarding early onset schizophrenia and psychotic mood disorders and emphasized the…

  16. Comparison of intensive case management for psychotic and nonpsychotic patients.

    PubMed

    Mohamed, Somaia

    2016-02-01

    While the original goal of intensive community-based service programs such as assertive community treatment (ACT) was reduction of hospital use, this goal has diminished in importance because of the extensive reduction in inpatient bed availability and use. This study sought to identify target populations that benefit most from such programs, hypothesizing that those with psychotic symptoms would show more benefits than others because of improved medication compliance. Administrative outcome data from the Department of Veterans Affairs Mental Health Intensive Case Management program from 2008-2011 were compared among 3 groups: (a) veterans clinically diagnosed with a psychotic disorder who also exhibited at least moderately severe psychotic symptoms (N = 2,502); (b) veterans with a psychotic disorder who did not exhibit such symptoms (N = 2,338); and (c) veterans with no psychotic diagnoses (N = 820). Baseline characteristics were compared to identify potentially confounding differences between the groups. Analysis of covariance (ANCOVA) was used to compare changes in symptoms, substance use, and community functioning 6 months after entry. Two significant differences were observed between the 3 groups after controlling for baseline measures, but not in the hypothesized direction, thus failing to confirm our hypothesis. Although we did not find evidence that patients with psychotic symptoms benefit any more from intensive community-based care than other participants, this study highlights a need to clarify the role of intensive case management (ICM) services in a context in which minimizing inpatient care plays is a less central objective, and tends to encourage offering ACT to selected patients with nonpsychotic disorders. PMID:26168139

  17. Psychotic symptoms in a woman with severe Anorexia Nervosa : psychotic symptoms in Anorexia Nervosa.

    PubMed

    Delsedime, Nadia; Nicotra, Barbara; Giovannone, Maria Cristina; Marech, Lucrezia; Barosio, Marta; Marzola, Enrica; Abbate-Daga, Giovanni; Fassino, Secondo

    2013-03-01

    With this paper we aimed to describe a case of a woman affected by Anorexia Nervosa Restricting subtype (AN-R) with delusional symptoms, visual hallucinations and severe body image distortion. We discussed the main AN diagnosis and whether delusional symptoms could be related to severity of AN describing also the use of olanzapine in such a severe clinical condition. The use of olanzapine was found to be effective to reduce both delusions and body distortions, and to improve compliance to treatments. We found a severe delusional symptomatology with mystic, omnipotence and persecution features. The psychotic structure seemed preceding the eating disorder and was also found to be worsened by emaciation. The use of antipsychotic helped reducing delusional symptoms and improving compliance to treatments. Finally, the dynamically oriented therapeutic relationship helped the patient to gain weight and to achieve a full recovery from psychotic symptoms. PMID:23757258

  18. Moving from Efficacy to Effectiveness in Eating Disorders Prevention: The Sorority Body Image Program

    ERIC Educational Resources Information Center

    Becker, Carolyn Black; Ciao, Anna C.; Smith, Lisa M.

    2008-01-01

    Although eating disorders prevention research has begun to produce programs with demonstrated efficacy, many such programs simply target individuals as opposed to engaging broader social systems (e.g., schools, sororities, athletic teams) as participant collaborators in eating disorders prevention. Yet, social systems ultimately will be…

  19. Complementary and alternative medicine for autism spectrum disorders: rationale, safety and efficacy.

    PubMed

    Whitehouse, Andrew J O

    2013-09-01

    Complementary and alternative medicine is widely used for children with autism spectrum disorder, despite uncertainty regarding efficacy. This review describes complementary and alternative practices commonly used among this population, the rationale for the use of each practice, as well as the side-effect profile and evidence for efficacy. The existing evidence base indicates that melatonin can be recommended as a treatment for sleeping disturbances associated with autism spectrum disorder, while secretin can be rejected as an efficacious treatment for broader autistic symptoms. There is insufficient evidence to draw conclusions on the efficacy of modified diets, hyperbaric oxygen therapy, immune therapy, and vitamin and fatty acid supplementation. There is a clear need for methodologically rigorous studies to provide evidence-based guidance to families and clinicians regarding complementary and alternative practices for individuals with autism spectrum disorders. PMID:23682728

  20. Effects of posttraumatic stress disorder and child sexual abuse on self-efficacy development.

    PubMed

    Diehl, Amy S; Prout, Maurice F

    2002-04-01

    The symptoms of child sexual abuse and posttraumatic stress disorder (PTSD) affect a child's self-efficacy. A child's self-efficacy beliefs impact the course and treatment of PTSD, because perceived self-efficacy plays a mediating role in children's ability to cope with trauma. Self-efficacy research indicates that emotional competence can be learned and may provide treatment for PTSD that provides symptom reduction as well as a means of substituting problem-solving coping skills for emotion-focused coping skills. PMID:15792065

  1. Self-efficacy and Quality of Life among People with Bipolar Disorder

    PubMed Central

    Abraham, Kristen M.; Miller, Christopher J.; Birgenheir, Denis G.; Lai, Zongshan; Kilbourne, Amy M.

    2014-01-01

    People with bipolar disorders report a lower quality of life than the general population, and few mutable factors associated with health-related quality of life (HRQoL) among people with bipolar disorders have been identified. Using a cross-sectional design, these analyses examined whether self-efficacy was associated with mental and physical HRQoL in a sample of 141 patients with bipolar disorder who completed baseline assessments for two randomized controlled trials. Multiple linear regression analyses indicated that higher levels of self-efficacy were associated with higher mental and physical HRQoL, after controlling for demographic factors and clinical factors (including mood symptoms, co-morbid medical conditions, and substance use). Future research should examine whether targeted treatments that aim to improve self-efficacy (such as self-management interventions) lead to improvements in HRQoL among people with bipolar disorder and other serious mental illnesses. PMID:25010107

  2. Diagnosis and evaluation of hallucinations and other psychotic symptoms in children and adolescents.

    PubMed

    Sikich, Linmarie

    2013-10-01

    Recognizing positive psychotic symptoms and their diagnostic context in youth is challenging. A large minority say they "hear things others do not hear," though they seldom present with complaints of hallucinations or delusions. Few have schizophrenia spectrum disorder, but many have other psychiatric disorders. Frequently, they have psychotic symptoms for an extended period before diagnosis. Clinicians should understand psychotic symptoms and their differential diagnoses. This article reviews the epidemiology, associated diagnoses, and prognosis of hallucinations and delusions in youth. Strategies for optimizing the clinical diagnostic interview, appropriate laboratory tests, indications for psychological testing, and rating scales are reviewed. PMID:24012079

  3. Medication adherence in patients with psychotic disorders: an observational survey involving patients before they switch to long-acting injectable risperidone

    PubMed Central

    Baylé, Franck Jean; Tessier, Arnaud; Bouju, Sophie; Misdrahi, David

    2015-01-01

    Background Maintaining antipsychotic therapy in psychosis is important in preventing relapse. Long-acting depot preparations can prevent covert non-adherence and thus potentially contribute to better patient outcomes. In this observational survey the main objective is to evaluate medication adherence and its determinants for oral treatment in a large sample of patients with psychosis. Methods In this cross-sectional survey medication adherence for oral treatment was assessed by patients using the patient-rated Medication Adherence Questionnaire (MAQ). Data were collected by physicians on patients with a recent acute psychotic episode before switching to long-acting injectable risperidone. Other evaluations included disease severity (Clinical Global Impression – Severity), patients’ insight (Positive and Negative Syndrome Scale item G12), treatment acceptance (clinician-rated Compliance Rating Scale), and therapeutic alliance (patient-rated 4-Point ordinal Alliance Scale). Results A total of 399 psychiatrists enrolled 1,887 patients (mean age 36.8±11.9 years; 61.6% had schizophrenia). Adherence to oral medication was “low” in 53.2% of patients, “medium” in 29.5%, and “high” in 17.3%. Of patients with psychiatrist-rated active acceptance of treatment, 70% had “medium” or “high” MAQ scores (P<0.0001). Medication adherence was significantly associated with therapeutic alliance (4-Point ordinal Alliance Scale score; P<0.0001). Patient age was significantly associated with adherence: mean age increased with greater adherence (35.6, 36.7, and 38.6 years for patients with “low”, “medium”, and “high” levels of adherence, respectively; P=0.0007), while age <40 years was associated with “low” MAQ classification (P=0.0003). Poor adherence was also associated with a diagnosis of schizophrenia (P=0.0083), more severe disease (Clinical Global Impression – Severity ≥4; P<0.0001), and lower insight (Positive and Negative Syndrome Scale

  4. Complementary treatment of psychotic and epileptic patients in malaysia.

    PubMed

    Razali, Salleh Mohd; Yassin, Azhar Mohd

    2008-09-01

    The objective of this article is to describe and compare the use of traditional/complementary medicine (T/CM) among psychotic (schizophrenia and schizophreniform disorder) and epileptic Malay patients in peninsular Malaysia. There were 60 patients in each group. T/CM consultation was uniformly spread across all levels of education and social status. We could not find a single over-riding factor that influenced the decision to seek T/CM treatment because the decision to seek such treatment was complex and the majority of decisions were made by others. Fifty-three patients (44.2%), consisting of 37 (61.7%) psychotic and 16 (26.7%) epileptic patients had consulted Malay traditional healers (bomoh) and/or homeopathic practitioners in addition to modern treatment; of these, only three had consulted bomoh and homeopathic practitioners at the same time. The use of T/CM was significantly higher in psychotic than in epileptic Malay patients. PMID:18799643

  5. Efficacy of Atomoxetine in Children with Severe Autistic Disorders and Symptoms of ADHD: An Open-Label Study

    ERIC Educational Resources Information Center

    Charnsil, Chawanun

    2011-01-01

    Objective: This study aims to examine the efficacy of atomoxetine in treating symptoms of attention deficit hyperactivity disorder (ADHD) in children with severe autistic disorder. Method: Children with severe autistic disorder who had symptoms of ADHD were given atomoxetine for 10 weeks. The efficacy of atomoxetine was evaluated by using the…

  6. Cerebral correlates of psychotic syndromes in neurodegenerative diseases

    PubMed Central

    Jellinger, Kurt A

    2012-01-01

    Abstract Psychosis has been recognized as a common feature in neurodegenerative diseases and a core feature of dementia that worsens most clinical courses. It includes hallucinations, delusions including paranoia, aggressive behaviour, apathy and other psychotic phenomena that occur in a wide range of degenerative disorders including Alzheimer’s disease, synucleinopathies (Parkinson’s disease, dementia with Lewy bodies), Huntington’s disease, frontotemporal degenerations, motoneuron and prion diseases. Many of these psychiatric manifestations may be early expressions of cognitive impairment, but often there is a dissociation between psychotic/behavioural symptoms and the rather linear decline in cognitive function, suggesting independent pathophysiological mechanisms. Strictly neuropathological explanations are likely to be insufficient to explain them, and a large group of heterogeneous factors (environmental, neurochemical changes, genetic factors, etc.) may influence their pathogenesis. Clinico-pathological evaluation of behavioural and psychotic symptoms (PS) in the setting of neurodegenerative and dementing disorders presents a significant challenge for modern neurosciences. Recognition and understanding of these manifestations may lead to the development of more effective preventive and therapeutic options that can serve to delay long-term progression of these devastating disorders and improve the patients’ quality of life. A better understanding of the pathophysiology and distinctive pathological features underlying the development of PS in neurodegenerative diseases may provide important insights into psychotic processes in general. PMID:21418522

  7. Auditory hallucination coping techniques and their relationship to psychotic symptomatology.

    PubMed

    Hayashi, Naoki; Igarashi, Yoshito; Suda, Kiyoko; Nakagawa, Seishu

    2007-12-01

    Use of coping techniques is of importance in the treatment for patients experiencing auditory hallucinations. Phenomenological features of auditory hallucinations and other psychotic symptoms are assumed to be factors influencing the coping activities. The aim of the present study was to determine psychotic symptoms including auditory hallucination phenomenological features that have effects on coping activities. The authors investigated 17 generally used coping techniques of 144 chronically psychotic patients who were currently experiencing auditory hallucination in DSM-IV schizophrenia or schizoaffective psychosis. Using factor analysis, scales characterizing the styles of coping application and efficacy were constructed. To assess the phenomenological features, the authors used the Matsuzawa Assessment Schedule for Auditory Hallucination (MASAH), which had been devised to assess four basic phenomenological features: intractability, delusion, influence, and externality. The Positive and Negative Syndrome Scale (PANSS) was also applied for the assessment of psychotic symptoms. Regression analyses were conducted to determine the features and symptoms that could have effects on coping activities. Constructed scales were those of distraction and counteraction styles for each of coping application and efficacy. It was found that MASAH influence and externality features had an activating effect on both distraction and counteraction coping application, and counteraction coping application, respectively, and that PANSS negative symptom clusters and MASAH delusion feature had an inhibiting effect on distraction and counteraction coping application, respectively. No salient factor for coping efficacy was recognized. The current study presents information on the relationship between coping activities and the psychotic experience features and symptoms, which can be of help for planning coping training programs. PMID:18081625

  8. Metabotropic glutamate receptor mGluR2/3 and mGluR5 binding in the anterior cingulate cortex in psychotic and nonpsychotic depression, bipolar disorder and schizophrenia: implications for novel mGluR-based therapeutics

    PubMed Central

    Matosin, Natalie; Fernandez-Enright, Francesca; Frank, Elisabeth; Deng, Chao; Wong, Jenny; Huang, Xu-Feng; Newell, Kelly A.

    2014-01-01

    Background Metabotropic glutamate receptors 2/3 (mGluR2/3) and 5 (mGluR5) are novel therapeutic targets for major depression (MD), bipolar disorder (BD) and schizophrenia. We aimed to determine whether mGluR2/3 and mGluR5 binding in the anterior cingulate cortex (ACC), a brain region essential for the regulation of mood, cognition and emotion, were differentially altered in these pathologies. Methods Using postmortem human brains derived from 2 cohorts, [3H]LY341495 binding to mGluR2/3 and [3H]MPEP binding to mGluR5 were measured by receptor autoradiography in the ACC. The first cohort comprised samples from individuals who had MD with psychosis (MDP), MD without psychosis (MDNP) and matched controls (n = 11–12 per group). The second cohort comprised samples from individuals who had MDNP, BD, schizophrenia and matched controls (n = 15 per group). Results No differences in mGluR2/3 or mGluR5 binding were observed in the MDP, MDNP, BD or schizophrenia groups compared with the control group (all p > 0.05). Importantly, there were also no differences in binding densities between the psychiatric disorders (p > 0.05). We did, however, observe age-related effects, with consistent negative associations between mGluR2/3 and age in the control group (r < −0.575, p < 0.025) and the psychotic disorder groups (MDP and schizophrenia: r = −0.765 to −0.515, p < 0.05), but not in the mood disorder groups (MDNP, BD). Limitations Replication in larger independent cohorts and medication-naive individuals would strengthen these findings. Conclusion Our findings suggest that mGluRs are unaltered in the ACC; however, the presence of altered receptor function cannot be discounted and requires further investigation. Taken together with previous studies, which report differential changes in mGluR2, 3 and 5 across these disorders, we suggest mGluRs may be affected in a brain region–specific manner. PMID:24949866

  9. The Role of Substance Abuse in Psychotic versus Personality Disordered Offenders Detained under the Dutch Entrustment Act (TBS): An Exploratory Study

    ERIC Educational Resources Information Center

    Goethals, Kris; Buitelaar, Jan; van Marle, Hjalmar

    2008-01-01

    Mentally disordered patients that abuse drugs or alcohol have a larger number of criminal convictions. Early starters who had their first conviction before the age of 18, especially, more often have a diagnosis of substance abuse and are more often intoxicated at the time of the offense compared to late starters. The present study involved four…

  10. Efficacy Profiles of Psychopharmacology: Divalproex Sodium in Conduct Disorder

    ERIC Educational Resources Information Center

    Khanzode, Leena A.; Saxena, Kirti; Kraemer, Helena; Chang, Kiki; Steiner, Hans

    2006-01-01

    Little is known about how deeply medication treatment penetrates different levels of the mind/brain system. Psychopathology consists of relatively simple constructs (e.g., anger, irritability), or complex ones (e.g., responsibility). This study examines the efficacy of a specific compound, divalproex sodium (DVPX), on the various levels of…

  11. French version validation of the psychotic symptom rating scales (PSYRATS) for outpatients with persistent psychotic symptoms

    PubMed Central

    2012-01-01

    Background Most scales that assess the presence and severity of psychotic symptoms often measure a broad range of experiences and behaviours, something that restricts the detailed measurement of specific symptoms such as delusions or hallucinations. The Psychotic Symptom Rating Scales (PSYRATS) is a clinical assessment tool that focuses on the detailed measurement of these core symptoms. The goal of this study was to examine the psychometric properties of the French version of the PSYRATS. Methods A sample of 103 outpatients suffering from schizophrenia or schizoaffective disorders and presenting persistent psychotic symptoms over the previous three months was assessed using the PSYRATS. Seventy-five sample participants were also assessed with the Positive And Negative Syndrome Scale (PANSS). Results ICCs were superior to .90 for all items of the PSYRATS. Factor analysis replicated the factorial structure of the original version of the delusions scale. Similar to previous replications, the factor structure of the hallucinations scale was partially replicated. Convergent validity indicated that some specific PSYRATS items do not correlate with the PANSS delusions or hallucinations. The distress items of the PSYRATS are negatively correlated with the grandiosity scale of the PANSS. Conclusions The results of this study are limited by the relatively small sample size as well as the selection of participants with persistent symptoms. The French version of the PSYRATS partially replicates previously published results. Differences in factor structure of the hallucinations scale might be explained by greater variability of its elements. The future development of the scale should take into account the presence of grandiosity in order to better capture details of the psychotic experience. PMID:23020603

  12. Perceived self-efficacy in parents of adolescents and adults with autism spectrum disorder.

    PubMed

    Weiss, Jonathan A; Tint, Ami; Paquette-Smith, Melissa; Lunsky, Yona

    2016-05-01

    Many parents of adolescents and adults with autism spectrum disorder experience difficulty accessing appropriate services for their children, and may report low levels of parent self-efficacy. In an effort to identify the factors that contribute to the difficulties these families face, this study examined the role of demographic, systemic, and clinical need variables as they relate to parents' experience of self-efficacy. Participants included 324 parents of individuals with autism spectrum disorder, 12-25 years of age. Results suggest that parent self-efficacy is related to a number of variables and not simply a child's clinical situation, including child age, parent immigrant status, barriers to service access, and caregiver burden. Given the crucial role that parents often play in the lives of individuals with autism spectrum disorder across the lifespan, it is important that service providers support the efforts of parents who provide and access care for their children. PMID:26019305

  13. Early psychotic experiences: Interventions, problems and perspectives.

    PubMed

    Dimitrakopoulos, S; Kollias, C; Stefanis, N C; Kontaxakis, V

    2015-01-01

    . Current research emphasizes on improving validity of inclusion criteria and formulating personalised and clinical stage- based intervention strategies. In order to do that, early psychosis recognition and intervention services are established throughout the world, trying to contribute in research by applying clinical, cognitive or neuropsychological criteria. Nevertheless, in the majority of so far conducted studies, samples sizes are considered small and duration of follow-up short, which are limitations yet to overcome. Other scientific voices argue that the UHR state might represent a non-specific risk factor for psychiatric disorders in general and not necessarily for psychosis and tend to examine the UHR and early intervention idea under the prism of subthreshold or early mental distress state. Either way, recognizing and intervening early in emerging psychiatric states, especially in those with psychotic or psychotic-like symptomatology, share indisputable benefits under the broader concept of prevention, setting a strong scientific-clinical rationale for service provision to help-seeking people and the possibility of changing the course for those with vulnerability to psychotic illnesses. PMID:25880383

  14. Correlates in the Endorsement of Psychotic Symptoms and Services Use: Findings from the Collaborative Psychiatric Epidemiology Surveys.

    PubMed

    Barragán, Armando; Yamada, Ann-Marie; Lee, Karen Kyeunghae; Barrio, Concepción

    2016-08-01

    Endorsement of psychotic symptoms serves as an indicator of significant health issues and interpersonal distress. Seeking services is the ultimate recourse for many individuals, yet few studies have assessed the help-seeking process in a nationally representative sample. This study, guided by Lewis-Fernández et al.'s (J Nerv Ment Dis 197(5):337-347, 2009) analyses, examined the association of lifetime endorsement of psychotic symptoms with demographic, clinical and support system variables and types of services received. Based on nationally weighted epidemiological data, 11.6 % of adults reported one or more psychotic symptoms. Psychotic symptoms were associated with poor physical and mental health, specifically depressive, anxiety, and substance use disorders. Respondents were more likely to receive services from both informal and mental health providers and were more likely to be hospitalized than those not endorsing psychotic symptoms. Study findings inform community efforts to develop comprehensive services for individuals experiencing psychotic symptoms. PMID:25693679

  15. Weight perceptions, disordered eating behaviors, and emotional self-efficacy among high school adolescents.

    PubMed

    Zullig, Keith J; Matthews-Ewald, Molly R; Valois, Robert F

    2016-04-01

    Although emotional disorders and disordered eating behaviors are known to be related, the relationship between emotional self-efficacy (ESE) and disordered eating is unknown. This study examined the relationship between ESE and disordered eating in a statewide sample of public high school adolescents (n=2566). The Centers for Disease Control Youth Risk Behavior Survey and an adolescent ESE scale were utilized. Logistic regression adjusted for key covariates explored the relationship between low ESE and disordered eating among selected race and gender groups. Self-perceived weight as underweight or overweight; and dieting, vomiting or taking laxatives, taking diet pills, and fasting to lose weight were each associated (p<.05) with lower levels of ESE for certain race/gender groups. Findings provide increased justification for tailoring disordered eating interventions and treatments to accommodate the highest risk groups. Measures of ESE should be considered for adolescent mental health assessments in fieldwork, research, and evaluation efforts. PMID:26697720

  16. EFFICACY OF LITHIUM PROPHYLAXIS IN BIPOLAR AFFECTIVE DISORDER

    PubMed Central

    Mathew, Manu R.K.; Chandrasekaran, R.; Shreeram, S.S.; Anand, I.

    1995-01-01

    Forty four patients attending the affective disorder clink at J1PMER Hospital who were on prophylactic lithium for bipolar affective disorder were studied, Intra-individual comparison for severity of illness was made between periods of similar duration with and without lithium prophylaxis. It was found that during lithium prophylaxis patients did significantly better on the following parameters: number of episodes of illness, duration of episodes, hospital admission, neuroleptic dosages and duration of antidepressant treatment. Of the 44 patients included in the study, 45% were good responders, 39% were partial responders and 16% were poor responders. Late age of onset was found to be a significant predictor of good response to lithium. PMID:21743706

  17. Lifetime autism spectrum features in a patient with a psychotic mixed episode who attempted suicide.

    PubMed

    Simoncini, Marly; Miniati, Mario; Vanelli, Federica; Callari, Antonio; Vannucchi, Giulia; Mauri, Mauro; Dell'Osso, Liliana

    2014-01-01

    We present a case report of a young man who attempted suicide during a mixed episode with psychotic symptoms. The patient's history revealed the lifetime presence of signs and features belonging to the autism spectrum realm that had been completely overlooked. We believe that this case is representative of an important and barely researched topic: what happens to children with nondiagnosed and nontreated subthreshold forms of autism when they grow old. The issue of early recognition of autism spectrum signs and symptoms is discussed, raising questions on the diagnostic boundaries between autism and childhood onset psychotic spectrums among patients who subsequently develop a full-blown psychotic disorder. PMID:25349762

  18. Lifetime Autism Spectrum Features in a Patient with a Psychotic Mixed Episode Who Attempted Suicide

    PubMed Central

    Vanelli, Federica; Vannucchi, Giulia; Mauri, Mauro; Dell'Osso, Liliana

    2014-01-01

    We present a case report of a young man who attempted suicide during a mixed episode with psychotic symptoms. The patient's history revealed the lifetime presence of signs and features belonging to the autism spectrum realm that had been completely overlooked. We believe that this case is representative of an important and barely researched topic: what happens to children with nondiagnosed and nontreated subthreshold forms of autism when they grow old. The issue of early recognition of autism spectrum signs and symptoms is discussed, raising questions on the diagnostic boundaries between autism and childhood onset psychotic spectrums among patients who subsequently develop a full-blown psychotic disorder. PMID:25349762

  19. Perceived Self-Efficacy in Parents of Adolescents and Adults with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Weiss, Jonathan A.; Tint, Ami; Paquette-Smith, Melissa; Lunsky, Yona

    2016-01-01

    Many parents of adolescents and adults with autism spectrum disorder experience difficulty accessing appropriate services for their children, and may report low levels of parent self-efficacy. In an effort to identify the factors that contribute to the difficulties these families face, this study examined the role of demographic, systemic, and…

  20. Preservice Teachers' Self Efficacy and Knowledge of Emotional and Behavioural Disorders

    ERIC Educational Resources Information Center

    Shillingford, Shani; Karlin, Nancy

    2014-01-01

    This research examined preservice teachers' knowledge of emotional and behavioural disorders (EBD) and their sense of efficacy. The participants included a convenience sample of 230 undergraduate general education and special education preservice teachers enrolled in teacher education classes. The age of the participants ranged from 19 to 51…

  1. Preliminary Efficacy of a Cognitive-Behavioral Treatment Program for Anxious Youth with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    White, Susan W.; Ollendick, Thomas; Scahill, Lawrence; Oswald, Donald; Albano, Anne Marie

    2009-01-01

    Anxiety is a commonly occurring psychiatric concern in adolescents with autism spectrum disorders (ASD). This pilot study examined the preliminary efficacy of a manual-based intervention targeting anxiety and social competence in four adolescents with high-functioning ASD. Anxiety and social functioning were assessed at baseline, midpoint,…

  2. Promoting Social Skill Development in Children with Pervasive Developmental Disorders: A Feasibility and Efficacy Study

    ERIC Educational Resources Information Center

    Koenig, Kathleen; White, Susan Williams; Pachler, Maryellen; Lau, Monika; Lewis, Moira; Klin, Ami; Scahill, Lawrence

    2010-01-01

    A randomized controlled design was employed to evaluate a social skills intervention for children with pervasive developmental disorders. Aims included evaluating the acceptability of the program and gathering preliminary evidence on efficacy. Forty-four children, ages 8-11 years, were randomly assigned to treatment or wait list. Treatment…

  3. Efficacy and Safety of Lisdexamfetamine Dimesylate in Adolescents with Attention-Deficit/Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Findling, Robert L.; Childress, Ann C.; Cutler, Andrew J.; Gasior, Maria; Hamdani, Mohamed; Ferreira-Cornwell, M. Celeste; Squires, Liza

    2011-01-01

    Objective: To examine lisdexamfetamine dimesylate (LDX) efficacy and safety versus placebo in adolescents with attention-deficit/hyperactivity disorder (ADHD). Method: Adolescents (13 through 17) with at least moderately symptomatic ADHD (ADHD Rating Scale IV: Clinician Version [ADHD-RS-IV] score greater than or equal to 28) were randomized to…

  4. Psychotic symptoms in young people warrant urgent referral.

    PubMed

    Deakin, Julia; Lennox, Belinda

    2013-03-01

    There is a worse prognosis for psychosis and schizophrenia when onset is in childhood or adolescence. However, outcomes are improved with early detection and treatment. Psychotic symptoms can be associated with a variety of disorders including schizophrenia, schizoaffective disorder, drug-induced psychosis, personality disorder, epilepsy and autistic spectrum disorder. Positive symptoms include hallucinations and delusions. Negative symptoms include apathy, lack of drive, poverty of speech, social withdrawal and self-neglect. The DSM IV criteria for schizophrenia include two or more of the following: hallucinations, delusions, disorganised speech, grossly disorganised or catatonic behaviour and negative symptoms. Adults may raise concerns about social withdrawal, bizarre ideas, a change in behaviour or a decline in achievement. Most children and young people with psychotic symptoms will not go on to develop psychosis or schizophrenia. Direct enquiry may be needed to elicit suspected unusual beliefs or hallucinations. To distinguish unusual ideas from delusions the ideas should be tested for fixity. For example by asking: 'Are you sure? Could there be another explanation?' Mood and anxiety symptoms should be explored. The assessment should include a developmental history with particular attention to premorbid functioning. Failure to make expected progress whether personal, social or academic is significant. Better outcomes in terms of symptoms and social function are associated with a shorter duration of untreated psychosis. The detection of psychotic symptoms in primary care therefore warrants an urgent referral to secondary care mental health services for assessment and treatment. PMID:23634636

  5. Rate and predictors of psychotic symptoms after Kashmir earthquake.

    PubMed

    Ayub, Muhammad; Saeed, Khalid; Kingdon, David; Naeem, Farooq

    2015-09-01

    Psychotic symptoms are more common in general population than validated diagnosis of psychosis. There is evidence to suggest that these symptoms, hallucinations, paranoia, elated mood, thought insertion, are part of a spectrum of psychosis and may have association with the same risk factors that determine development of psychosis. These symptoms have an association with exposure to psychological trauma, post-traumatic stress disorder, anxiety and depression. The aim of this study was to explore the prevalence of psychotic symptoms in the population affected by a natural disaster, earthquake in this case and possible correlates of these symptoms. We conducted a cross-sectional survey of a population sample affected by the disaster, comprising of 1,291 individuals, 18 months after 2005 earthquake in Northern Pakistan and Kashmir to look at the prevalence of these symptoms and their correlates. Screening Instrument for Traumatic Stress in Earthquake Survivors and Self-Reporting Questionnaire and Psychosis Screening Questionnaire were used as tools. We examined association between the symptoms of anxiety, depression, PTSD and psychotic symptoms. We performed logistic regression analysis where hallucinations and delusions were dependent variables and demographic and trauma exposure variables were independent variables. The prevalence of psychotic symptoms ranged between 16.8 and 30.4 %. They were directly correlated with symptoms of post-traumatic stress disorder as well as concurrent symptoms of anxiety and depression. Lower level of education had a strong association in all the regression models. For hallucinations, living in a joint family had a negative association and participation in rescue, history of exposure to previous trauma and past psychiatric history had positive association. Paranoia was associated with female gender. Any psychiatric symptom was associated death of a family member, history of past psychiatric illness and living in a tent at the time of

  6. Clinical features of psychotic disorders and polymorphisms in HT2A, DRD2, DRD4, SLC6A3 (DAT1), and BDNF: a family based association study.

    PubMed

    Fanous, Ayman H; Neale, M C; Straub, R E; Webb, B T; O'Neill, A F; Walsh, D; Kendler, K S

    2004-02-15

    Schizophrenia is clinically heterogeneous and multidimensional, but it is not known whether this is due to etiological heterogeneity. Previous studies have not consistently reported association between any specific polymorphisms and clinical features of schizophrenia, and have primarily used case-control designs. We tested for the presence of association between clinical features and polymorphisms in the genes for the serotonin 2A receptor (HT2A), dopamine receptor types 2 and 4, dopamine transporter (SLC6A3), and brain-derived neurotrophic factor (BDNF). Two hundred seventy pedigrees were ascertained on the basis of having two or more members with schizophrenia or poor outcome schizoaffective disorder. Diagnoses were made using a structured interview based on the SCID. All patients were rated on the major symptoms of schizophrenia scale (MSSS), integrating clinical and course features throughout the course of illness. Factor analysis revealed positive, negative, and affective symptom factors. The program QTDT was used to implement a family-based test of association for quantitative traits, controlling for age and sex. We found suggestive evidence of association between the His452Tyr polymorphism in HT2A and affective symptoms (P = 0.02), the 172-bp allele of BDNF and negative symptoms (P = 0.04), and the 480-bp allele in SLC6A3 (= DAT1) and negative symptoms (P = 0.04). As total of 19 alleles were tested, we cannot rule out false positives. However, given prior evidence of involvement of the proteins encoded by these genes in psychopathology, our results suggest that more attention should be focused on the impact of these alleles on clinical features of schizophrenia. PMID:14755448

  7. Self-Amputation in Two Non-Psychotic Patients

    PubMed Central

    Rahmanian, Hamid; Petrou, Nikoletta A.; Sarfraz, M. Aamer

    2015-01-01

    Self-amputation, the extreme form of self-mutilation, is uncommon. The vast majority of cases are associated with psychosis, with a small number being assigned the controversial diagnosis of body identity integrity disorder. In this article, we report two cases of non-psychotic self-amputation and their similarities with a view to highlighting the risk factors and formulating an appropriate management plan. PMID:26576171

  8. Self-Amputation in Two Non-Psychotic Patients.

    PubMed

    Rahmanian, Hamid; Petrou, Nikoletta A; Sarfraz, M Aamer

    2015-09-01

    Self-amputation, the extreme form of self-mutilation, is uncommon. The vast majority of cases are associated with psychosis, with a small number being assigned the controversial diagnosis of body identity integrity disorder. In this article, we report two cases of non-psychotic self-amputation and their similarities with a view to highlighting the risk factors and formulating an appropriate management plan. PMID:26576171

  9. Anxiety sensitivity, catastrophic misinterpretations and panic self-efficacy in the prediction of panic disorder severity: towards a tripartite cognitive model of panic disorder.

    PubMed

    Sandin, Bonifacio; Sánchez-Arribas, Carmen; Chorot, Paloma; Valiente, Rosa M

    2015-04-01

    The present study examined the contribution of three main cognitive factors (i.e., anxiety sensitivity, catastrophic misinterpretations of bodily symptoms, and panic self-efficacy) in predicting panic disorder (PD) severity in a sample of patients with a principal diagnosis of panic disorder. It was hypothesized that anxiety sensitivity (AS), catastrophic misinterpretation of bodily sensations, and panic self-efficacy are uniquely related to panic disorder severity. One hundred and sixty-eight participants completed measures of AS, catastrophic misinterpretations of panic-like sensations, and panic self-efficacy prior to receiving treatment. Results of multiple linear regression analyses indicated that AS, catastrophic misinterpretations and panic self-efficacy independently predicted panic disorder severity. Results of path analyses indicated that AS was direct and indirectly (mediated by catastrophic misinterpretations) related with panic severity. Results provide evidence for a tripartite cognitive account of panic disorder. PMID:25727680

  10. Efficacy and Safety of Risperidone and Quetiapine in Adolescents With Bipolar II Disorder Comorbid With Conduct Disorder.

    PubMed

    Masi, Gabriele; Milone, Annarita; Stawinoga, Agnieszka; Veltri, Stefania; Pisano, Simone

    2015-10-01

    Although a frequent co-occurrence between bipolar disorder (BD) and conduct disorder (CD) in youth has been frequently reported, data about pharmacological management are scarce and focused on BD type I. Second generation antipsychotics are frequently used in clinical practice, but no comparative studies are available. The aim of this exploratory study was to compare efficacy and safety of risperidone and quetiapine in a sample of adolescents presenting a BD type II comorbid with CD. Twenty-two patients diagnosed with a structured interview according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, (male/female ratio, 12/10; mean (SD) age 15.0 (1.4) years) were randomized in 2 treatment groups (quetiapine [n = 12] vs risperidone [n = 10]), treated with flexible doses, and followed up for 12 weeks. Efficacy measures assessed manic symptoms, aggression, anxiety, depression, global clinical severity, and impairment. Safety measures included body mass index, serum prolactin, extrapyramidal adverse effects, and electrocardiogram. At the end of the study, all patients improved in all efficacy measures. Both treatments showed similar efficacy in reducing manic symptoms and aggression. Quetiapine was more effective in improving anxiety and depressive symptoms. A change in body mass index was found, and in a post hoc analysis, it was significant only in the risperidone group. Prolactin significantly increased only in the risperidone group. In BD type II, CD comorbidity, quetiapine, or risperidone monotherapy may be effective and relatively safe, although the small sample size, the limited duration of the study, and the design (lack of a blind assessments and of a placebo group) make it difficult to draw definitive conclusions. PMID:26226481

  11. Efficacy of Electroconvulsive Therapy in Bipolar Disorder with Mixed Features.

    PubMed

    Palma, Miguel; Ferreira, Berta; Borja-Santos, Nuno; Trancas, Bruno; Monteiro, Céu; Cardoso, Graça

    2016-01-01

    Introduction. Mixed states represent a frequent presentation of bipolar disorder, associated with higher resistance to psychopharmacology. Limited evidence supports the use of ECT in these patients. We aim to report our experience on treating bipolar mixed states with ECT. Methods. Retrospective data were collected from all bipolar patients submitted to acute ECT treatment, between June 2006 and June 2011. Three groups were created in terms of affective polarity of the episode. CGI rating was used to establish clinical remission and demographic and clinical variables were compared among groups. Long-term outcome was assessed through readmission measures, considering the use of continuation or maintenance ECT. Results. During the study time frame, a total of 50 ECT course treatments were performed on 41 bipolar patients. All affective episodes, except one mixed state, showed a positive clinical response. Patients with mixed state presentation tended to be younger and have an earlier first hospitalization than depressed patients. No differences were found in terms of ECT sessions performed, length of hospital admission, referral to continuation ECT treatment, number of readmissions, and time until next readmission. Conclusions. Our results support the effectiveness of ECT in patients experiencing a mixed affective state. PMID:26881069

  12. Efficacy of Electroconvulsive Therapy in Bipolar Disorder with Mixed Features

    PubMed Central

    Ferreira, Berta; Borja-Santos, Nuno; Trancas, Bruno; Monteiro, Céu; Cardoso, Graça

    2016-01-01

    Introduction. Mixed states represent a frequent presentation of bipolar disorder, associated with higher resistance to psychopharmacology. Limited evidence supports the use of ECT in these patients. We aim to report our experience on treating bipolar mixed states with ECT. Methods. Retrospective data were collected from all bipolar patients submitted to acute ECT treatment, between June 2006 and June 2011. Three groups were created in terms of affective polarity of the episode. CGI rating was used to establish clinical remission and demographic and clinical variables were compared among groups. Long-term outcome was assessed through readmission measures, considering the use of continuation or maintenance ECT. Results. During the study time frame, a total of 50 ECT course treatments were performed on 41 bipolar patients. All affective episodes, except one mixed state, showed a positive clinical response. Patients with mixed state presentation tended to be younger and have an earlier first hospitalization than depressed patients. No differences were found in terms of ECT sessions performed, length of hospital admission, referral to continuation ECT treatment, number of readmissions, and time until next readmission. Conclusions. Our results support the effectiveness of ECT in patients experiencing a mixed affective state. PMID:26881069

  13. A longitudinal investigation of childhood communication ability and adolescent psychotic experiences in a community sample

    PubMed Central

    Sullivan, Sarah A.; Hollen, Linda; Wren, Yvonne; Thompson, Andrew D.; Lewis, Glyn; Zammit, Stan

    2016-01-01

    Background Some childhood speech and language impairments precede psychosis but it is not clear whether they also precede adolescent psychotic experiences and whether this association is specific to psychotic experiences. Methods Pragmatic language and expressive speech and language (parent-assessed using the Children's Communication Checklist) at age 9 and psychotic experiences and depression at ages 12 and 18 were investigated in 7659 participants from the Avon Longitudinal Study of Parents and Children. Associations were investigated using multivariate modelling. Results Poorer pragmatic language at 9 years was associated with psychotic experiences at both ages (12 years OR 1.22, 95% CI 1.11, 1.34; 18 years OR 1.25, 95% CI 1.10, 1.41) but only with depression at 18 years (OR 1.10, 95% CI 1.00, 1.22). Poorer expressive speech and language ability was not associated with psychotic experiences or depression at either age. There was evidence that pragmatic language was specifically associated with psychotic experiences at age 12 but no evidence that the strength of any of the associations changed over time. Conclusions Deficits in pragmatic language precede early and late adolescent psychotic experiences and early adolescent depression. Interventions aimed at helping children improve pragmatic language skills may reduce the incidence of adolescent psychopathology and associated psychological disorder and dysfunction later in life. PMID:26972475

  14. Empowerment, feminism, and self-efficacy: relationships to body image and disordered eating.

    PubMed

    Kinsaul, Jessica A E; Curtin, Lisa; Bazzini, Doris; Martz, Denise

    2014-01-01

    Sociocultural norms pertaining to an ideal of thinness for women likely play a role in the development and maintenance of disturbance in body image, and by extension, disordered eating. However, competing norms associated with feminism may buffer women from pressures associated with achieving the thin ideal. The present study explored the relationship between feminist ideology, empowerment, and self-efficacy relative to body image and eating behavior with a sample of U.S. undergraduate women (N=318) attending a southeastern U.S. mid-sized university. In planned hierarchical multiple regression analyses, endorsement of feminist ideology predicted perceptions of positive body image, but did not appear to predict disordered eating. Self-efficacy emerged as a robust predictor of positive body image and lower disordered eating even after controlling for perceptions of personal empowerment and feminism. Results, although limited by correlational data, suggest that self-efficacy may protect college-aged women from disordered eating and negative body image. PMID:24018338

  15. Attacks on the British Royal family: the role of psychotic illness.

    PubMed

    James, David V; Mullen, Paul E; Pathé, Michele T; Meloy, J Reid; Farnham, Frank R; Preston, Lulu; Darnley, Brian

    2008-01-01

    The role of psychotic disorders in attacks on British Royalty is examined. In the 23 attacks, there was evidence of psychotic illness at the time in 11 (48%) cases, with evidence of mental disorder in 4 additional ones. These data almost certainly underestimate the contribution of major mental disorder, as psychiatric evaluations were not available on several attackers. Psychotic states do not, however, preclude a rational element to the attackers' grievances. The objective of most attackers was to commit an outrageous act to bring attention to grievances. Nine attackers had stalked their victims. Greater attention to psychiatric disorder among those who harass royalty or other public figures would allow early intervention. Ensuring that the obviously mentally ill stalkers of prominent persons are referred to psychiatric services would meet the needs of most of them for treatment and care, while reducing the chances that a tiny minority will progress to attack. PMID:18354125

  16. Efficacy and safety of the probiotic Saccharomyces boulardii for the prevention and therapy of gastrointestinal disorders

    PubMed Central

    Kelesidis, Theodoros

    2012-01-01

    Several clinical trials and experimental studies strongly suggest a place for Saccharomyces boulardii as a biotherapeutic agent for the prevention and treatment of several gastrointestinal diseases. S. boulardii mediates responses resembling the protective effects of the normal healthy gut flora. The multiple mechanisms of action of S. boulardii and its properties may explain its efficacy and beneficial effects in acute and chronic gastrointestinal diseases that have been confirmed by clinical trials. Caution should be taken in patients with risk factors for adverse events. This review discusses the evidence for efficacy and safety of S. boulardii as a probiotic for the prevention and therapy of gastrointestinal disorders in humans. PMID:22423260

  17. Role of quetiapine beyond its clinical efficacy in bipolar disorder: From neuroprotection to the treatment of psychiatric disorders (Review)

    PubMed Central

    SOEIRO-DE-SOUZA, MÁRCIO G.; DIAS, VASCO VIDEIRA; MISSIO, GIOVANNI; BALANZÁ-MARTINEZ, VICENT; VALIENGO, LEANDRO; CARVALHO, ANDRÉ F.; MORENO, RICARDO ALBERTO

    2015-01-01

    The aim of the present review was to discuss the following aspects of treatment with quetiapine in psychiatric disorders: i) Neurocognition and functional recovery in bipolar disorder (BD); ii) neuroprotective profile in different models; and iii) potential off-label indications. A PubMed search was conducted of articles published in English between 2000 and 2012 on quetiapine, cross-referenced with the terms ‘anxiety’, ‘attention deficit disorder’, ‘borderline personality disorder’, ‘dementia’, ‘insomnia’, ‘major depressive disorder’ (MDD), ‘obsessive-compulsive disorder’, ‘post-traumatic stress disorder’, ‘remission’, ‘cognition’, ‘neurobiology’, ‘neuroprotection’, ‘efficacy’ and ‘effectiveness’. Articles were selected from meta-analyses, randomized clinical trials and open trials, and the results were summarized. Quetiapine, when studied in off-label conditions, has shown efficacy as a monotherapy in MDD and general anxiety disorder. Quetiapine also appears to exhibit a small beneficial effect in dementia. The review of other conditions was affected by methodological limitations that precluded any definitive conclusions on the efficacy or safety of quetiapine. Overall, the present review shows evidence supporting a potential role for quetiapine in improving cognition, functional recovery and negative symptoms in a cost-effective manner in BD. These benefits of quetiapine are potentially associated with its well-described neuroprotective effects; however, further studies are clearly warranted. PMID:25667608

  18. Childhood Parasomnias and Psychotic Experiences at Age 12 Years in a United Kingdom Birth Cohort

    PubMed Central

    Fisher, Helen L.; Lereya, Suzet Tanya; Thompson, Andrew; Lewis, Glyn; Zammit, Stanley; Wolke, Dieter

    2014-01-01

    Study Objectives: To examine associations between specific parasomnias and psychotic experiences in childhood. Design: Birth cohort study. Information on the presence of frequent nightmares in children was obtained prospectively from mothers during multiple assessments conducted when children were aged between 2.5 and 9 y. Children were interviewed at age 12 y about nightmares, night terrors, sleepwalking, and psychotic experiences (delusions, hallucinations, and thought interference) occurring in the previous 6 mo. Setting: Assessments were completed in participants' homes or a University clinic within the UK. Patients or Participants: There were 6,796 children (3,462 girls, 50.9%) who completed the psychotic experiences interview. Measurements and Results: Children who were reported by their mothers as experiencing frequent nightmares between 2.5 and 9 y of age were more likely to report psychotic experiences at age 12 y, regardless of sex, family adversity, emotional or behavioral problems, IQ and potential neurological problems (odds ratio (OR) = 1.16, [95% confidence intervals (CI) = 1.00, 1.35], P = 0.049). Children reporting any of the parasomnias at age 12 y also had higher rates of concurrent psychotic experiences than those without such sleeping problems, when adjusting for all confounders (OR = 3.62 [95% CI = 2.57, 5.11], P < 0.001). Difficulty getting to sleep and night waking were not found to be associated with psychotic experiences at age 12 y when controlling for confounders. Conclusion: Nightmares and night terrors, but not other sleeping problems, in childhood were associated with psychotic experiences at age 12 years. These findings tentatively suggest that arousal and rapid eye movement forms of sleep disorder might be early indicators of susceptibility to psychotic experiences. Citation: Fisher HL; Lereya ST; Thompson A; Lewis G; Zammit S; Wolke D. Childhood parasomnias and psychotic experiences at age 12 years in a United Kingdom birth cohort

  19. The Association between Negative Symptoms, Psychotic Experiences and Later Schizophrenia: A Population-Based Longitudinal Study

    PubMed Central

    Werbeloff, Nomi; Dohrenwend, Bruce P.; Yoffe, Rinat; van Os, Jim; Davidson, Michael; Weiser, Mark

    2015-01-01

    Background Psychotic experiences are common in the general population, and predict later psychotic illness. Much less is known about negative symptoms in the general population. Method This study utilized a sample of 4,914 Israel-born individuals aged 25–34 years who were screened for psychopathology in the 1980's. Though not designed to specifically assess negative symptoms, data were available on 9 self-report items representing avolition and social withdrawal, and on 5 interviewer-rated items assessing speech deficits, flat affect and poor hygiene. Psychotic experiences were assessed using the False Beliefs and Perceptions subscale of the Psychiatric Epidemiology Research Interview. Psychiatric hospitalization was ascertained 24 years later using a nation-wide psychiatric hospitalization registry. Results After removing subjects with diagnosable psychotic disorders at baseline, 20.2% had at least one negative symptom. Negative symptoms were associated with increased risk of later schizophrenia only in the presence of strong (frequent) psychotic experiences (OR = 13.0, 9% CI: 2.1–79.4). Conclusions Negative symptoms are common in the general population, though the majority of people with negative symptoms do not manifest a clinically diagnosed psychiatric disorder. Negative symptoms and psychotic experiences critically depend on each other’s co-occurrence in increasing risk for later schizophrenia. PMID:25748557

  20. Efficacy of telephone-administered behavioral therapy for panic disorder with agoraphobia.

    PubMed

    Swinson, R P; Fergus, K D; Cox, B J; Wickwire, K

    1995-05-01

    The purpose of this study was to determine the efficacy of a structured exposure-based behavior therapy program delivered by telephone to agoraphobic individuals who were isolated from specialized treatment centres. Forty-two individuals with a DSM-III-R diagnosis of panic disorder with agoraphobia who were living in rural areas of Ontario were assigned to either an eight-session telephone behavior therapy program or wait-list control condition. There were significant treatment x time interaction effects on several outcome variables. Patients originally in the wait-list group then received the same type of therapy and they also significantly improved. All treatment gains were maintained at three-month and six-month follow-up. Telephone behavior therapy appears to be a cost-effective and efficacious treatment for agoraphobics living in remote regions where specialized anxiety disorder services are not readily available. PMID:7755536

  1. Sensory integration dysfunction affects efficacy of speech therapy on children with functional articulation disorders

    PubMed Central

    Tung, Li-Chen; Lin, Chin-Kai; Hsieh, Ching-Lin; Chen, Ching-Chi; Huang, Chin-Tsan; Wang, Chun-Hou

    2013-01-01

    Background Articulation disorders in young children are due to defects occurring at a certain stage in sensory and motor development. Some children with functional articulation disorders may also have sensory integration dysfunction (SID). We hypothesized that speech therapy would be less efficacious in children with SID than in those without SID. Hence, the purpose of this study was to compare the efficacy of speech therapy in two groups of children with functional articulation disorders: those without and those with SID. Method: A total of 30 young children with functional articulation disorders were divided into two groups, the no-SID group (15 children) and the SID group (15 children). The number of pronunciation mistakes was evaluated before and after speech therapy. Results: There were no statistically significant differences in age, sex, sibling order, education of parents, and pretest number of mistakes in pronunciation between the two groups (P > 0.05). The mean and standard deviation in the pre- and post-test number of mistakes in pronunciation were 10.5 ± 3.2 and 3.3 ± 3.3 in the no-SID group, and 10.1 ± 2.9 and 6.9 ± 3.5 in the SID group, respectively. Results showed great changes after speech therapy treatment (F = 70.393; P < 0.001) and interaction between the pre/post speech therapy treatment and groups (F = 11.119; P = 0.002). Conclusions: Speech therapy can improve the articulation performance of children who have functional articulation disorders whether or not they have SID, but it results in significantly greater improvement in children without SID. SID may affect the treatment efficiency of speech therapy in young children with articulation disorders. PMID:23355780

  2. Are Genetic Risk Factors for Psychosis Also Associated with Dimension-Specific Psychotic Experiences in Adolescence?

    PubMed Central

    Sieradzka, Dominika; Power, Robert A.; Freeman, Daniel; Cardno, Alastair G.; McGuire, Philip; Plomin, Robert; Meaburn, Emma L.; Dudbridge, Frank; Ronald, Angelica

    2014-01-01

    Psychosis has been hypothesised to be a continuously distributed quantitative phenotype and disorders such as schizophrenia and bipolar disorder represent its extreme manifestations. Evidence suggests that common genetic variants play an important role in liability to both schizophrenia and bipolar disorder. Here we tested the hypothesis that these common variants would also influence psychotic experiences measured dimensionally in adolescents in the general population. Our aim was to test whether schizophrenia and bipolar disorder polygenic risk scores (PRS), as well as specific single nucleotide polymorphisms (SNPs) previously identified as risk variants for schizophrenia, were associated with adolescent dimension-specific psychotic experiences. Self-reported Paranoia, Hallucinations, Cognitive Disorganisation, Grandiosity, Anhedonia, and Parent-rated Negative Symptoms, as measured by the Specific Psychotic Experiences Questionnaire (SPEQ), were assessed in a community sample of 2,152 16-year-olds. Polygenic risk scores were calculated using estimates of the log of odds ratios from the Psychiatric Genomics Consortium GWAS stage-1 mega-analysis of schizophrenia and bipolar disorder. The polygenic risk analyses yielded no significant associations between schizophrenia and bipolar disorder PRS and the SPEQ measures. The analyses on the 28 individual SNPs previously associated with schizophrenia found that two SNPs in TCF4 returned a significant association with the SPEQ Paranoia dimension, rs17512836 (p-value = 2.57×10−4) and rs9960767 (p-value = 6.23×10−4). Replication in an independent sample of 16-year-olds (N = 3,427) assessed using the Psychotic-Like Symptoms Questionnaire (PLIKS-Q), a composite measure of multiple positive psychotic experiences, failed to yield significant results. Future research with PRS derived from larger samples, as well as larger adolescent validation samples, would improve the predictive power to test these hypotheses

  3. The association between childhood autistic traits and adolescent psychotic experiences is explained by general neuropsychiatric problems.

    PubMed

    Cederlöf, Martin; Pettersson, Erik; Sariaslan, Amir; Larsson, Henrik; Östberg, Per; Kelleher, Ian; Långström, Niklas; Gumpert, Clara Hellner; Lundström, Sebastian; Lichtenstein, Paul

    2016-03-01

    Studies suggest associations between childhood autistic traits and adolescent psychotic experiences. However, recent research suggests that a general neuropsychiatric problems factor predicts adverse outcomes better than specific diagnostic entities. To examine if the alleged association between autistic traits and psychotic experiences could rather be explained by a general neuropsychiatric problems factor comprising symptoms of ADHD, tic disorder, developmental coordination disorder, and learning disorder, we conducted a prospective cohort study based on the Child and Adolescent Twin Study in Sweden. In addition, we examined the genetic and environmental influences on the associations. A total of 9,282 twins with data on childhood autistic traits and other neuropsychiatric problems, and follow-up data on psychotic experiences at ages 15 and/or 18 years were included. First, psychotic experiences were regressed on autistic traits and second, the general neuropsychiatric problems factor was added to the model. Auditory hallucinations were analyzed separately from the other psychotic experiences. Finally, twin analyses were employed to disentangle genetic from environmental influences in the observed associations. Replicating prior research, significant associations were found between autistic traits in childhood and auditory hallucinations at ages 15 and 18. However, after controlling for the general neuropsychiatric problems factor, the associations between autistic traits and auditory hallucinations disappeared, whereas the association between the general neuropsychiatric problems factor and auditory hallucinations persisted after controlling for autistic traits. Twin analyses revealed that the association between the general neuropsychiatric problems factor and auditory hallucinations was driven by shared genetic influences. © 2015 Wiley Periodicals, Inc. PMID:26464122

  4. Influence of Inflammatory Disorders and Infection on Iron Absorption and Efficacy of Iron- Fortified Foods

    PubMed Central

    Hurrell, Richard F.

    2014-01-01

    The provision of iron- fortified foods is a common strategy to prevent iron deficiency; however, ensuring adequate iron absorption is a challenge. Iron bioavailability depends on the choice of iron compound, the presence enhancers and inhibitors of absorption in the food matrix, and the physiological state of the consumer, including iron status, other nutritional deficiencies and inflammatory disorders. Inflammation associated with infections and inflammatory disorders would be expected to decrease iron absorption and reduce the efficacy of iron- fortified foods. The decreased absorption is due to an increase in circulating hepcidin in response to inflammatory cytokines. Hepcidin degrades ferroportin and blocks the passage of iron from the intestinal cell to the plasma. This is the innate immune response to infections and aims to restrict pathogen growth by restricting iron supply. Stable isotope studies have reported women and children with chronic malaria parasitemia or febrile malaria to have increased inflammatory cytokines, increased hepcidin and much decreased iron absorption. No studies have specifically investigated the efficacy of iron- fortified foods in the absence and presence of infections. In contrast, inflammation and increased hepcidin associated with adiposity in overweight have been linked to both lower iron absorption and the decreased efficacy of iron- fortified foods. PMID:25762975

  5. Efficacy of Cognitive-Behavioral Therapy in Pediatric Obsessive-Compulsive Disorder: A Meta-Analysis.

    PubMed

    Wu, Yanqiu; Lang, Zhiqiang; Zhang, Haitao

    2016-01-01

    BACKGROUND Pediatric obsessive-compulsive disorder (OCD) is a debilitating psychological anxiety disorder. Cognitive-behavioral therapy (CBT) has been shown to be an effective therapy for OCD, but the evaluation results from various studies are inconsistent and incomprehensive. This meta-analysis examined the efficacy of CBT in treatment of OCD. MATERIAL AND METHODS A literature search identified 13 studies that met the inclusion criteria. The efficacy of CBT on OCD was evaluated by comparing post-treatment and pre-treatment Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS) scores. Weighted mean difference (WMD) was generated for the statistical evaluation. Heterogeneity was evaluated by I2 index. RESULTS A decrease in WMD and a statistical significance (p<0.0001) in both CY-BOCS and CGI scores between pre- and post-CBT treatment were observed in both overall database (-11.73) and USA subgroup (-11.371), which indicates a dramatic relief of OCD symptoms after CBT treatment. Heterogeneity was detected in overall database and USA subgroup, which resulted in an application of the random-effects model to both groups. Publication bias was examined by both Begg's funnel plot and Egger's test and no publication bias was detected. CONCLUSIONS We concluded that CBT is efficacious in treating children's OCD. PMID:27182928

  6. Efficacy of Cognitive-Behavioral Therapy in Pediatric Obsessive-Compulsive Disorder: A Meta-Analysis

    PubMed Central

    Wu, Yanqiu; Lang, Zhiqiang; Zhang, Haitao

    2016-01-01

    Background Pediatric obsessive-compulsive disorder (OCD) is a debilitating psychological anxiety disorder. Cognitive-behavioral therapy (CBT) has been shown to be an effective therapy for OCD, but the evaluation results from various studies are inconsistent and incomprehensive. This meta-analysis examined the efficacy of CBT in treatment of OCD. Material/Methods A literature search identified 13 studies that met the inclusion criteria. The efficacy of CBT on OCD was evaluated by comparing post-treatment and pre-treatment Children’s Yale-Brown Obsessive Compulsive Scale (CY-BOCS) scores. Weighted mean difference (WMD) was generated for the statistical evaluation. Heterogeneity was evaluated by I2 index. Results A decrease in WMD and a statistical significance (p<0.0001) in both CY-BOCS and CGI scores between pre- and post-CBT treatment were observed in both overall database (−11.73) and USA subgroup (−11.371), which indicates a dramatic relief of OCD symptoms after CBT treatment. Heterogeneity was detected in overall database and USA subgroup, which resulted in an application of the random-effects model to both groups. Publication bias was examined by both Begg’s funnel plot and Egger’s test and no publication bias was detected. Conclusions We concluded that CBT is efficacious in treating children’s OCD. PMID:27182928

  7. The relationship between bullying, psychotic-like experiences and appraisals in 14-16-year olds.

    PubMed

    Campbell, Michelle L C; Morrison, Anthony P

    2007-07-01

    The psychological consequences of bullying have been the focus of much research over the last 25 years. However, the relationship between bullying and psychotic experiences has been relatively ignored despite the weight of evidence which suggests that traumatic events in childhood are significantly related to psychotic disorders. 373 pupils aged between 14 and 16 years took part in the study. They were asked to complete a number of self-report measures which examined their experience of bullying, predisposition to auditory hallucinations, paranoia and dissociation, and beliefs about both the self and the world and about paranoia. It was found that bullying was significantly associated with predisposition to psychotic experiences. Negative post-trauma cognitions were also associated with predisposition to psychotic phenomena as were positive beliefs about paranoia. Being bullied at school and beliefs about trauma and psychotic symptoms may contribute to the development of psychosis. However, it is also possible that these results indicate that experiencing psychotic-like phenomena increases the likelihood that a pupil's interpersonal context is characterised by peer hostility and rejection. The implications of these results are discussed. PMID:17229400

  8. Psychotic-Like Experiences and Their Cognitive Appraisal Under Short-Term Sensory Deprivation

    PubMed Central

    Daniel, Christina; Lovatt, Anna; Mason, Oliver John

    2014-01-01

    Aims: This study aimed to establish and compare the effects of brief sensory deprivation on individuals differing in trait hallucination proneness. Method: Eighteen participants selected for high hallucination proneness were compared against 18 participants rating low on this trait. The presence of psychotic-like experiences (PLEs), and participants’ cognitive appraisals of these, was evaluated in three different settings: at baseline, in a “secluded office” environment, and in light-and-sound sensory deprivation. Results: Psychotic-like experiences were experienced significantly more often in sensory deprivation for both groups. In particular, both experienced slight increases in perceptual distortions and anhedonia in seclusion, and these increased further during sensory deprivation. Highly hallucination prone individuals showed a significantly greater increase in perceptual distortions in sensory deprivation than did non-prone individuals suggesting a state-trait interaction. Their appraisals of these anomalous experiences were compared to both clinical and non-clinical individuals experiencing psychotic symptoms in everyday life. Conclusion: Short-term sensory deprivation is a potentially useful paradigm to model psychotic experiences, as it is a non-pharmacological tool for temporarily inducing psychotic-like states and is entirely safe at short duration. Experiences occur more frequently, though not exclusively, in those at putative risk of a psychotic disorder. The appraisals of anomalous experiences arising are largely consistent with previous observations of non-clinical individuals though importantly lacked the general positivity of the latter. PMID:25177302

  9. The Efficacy of the Tomatis Method for Children with Learning and Communication Disorders: A Meta-Analysis.

    ERIC Educational Resources Information Center

    Gilmor, Tim

    1999-01-01

    Explains the Tomatis Method, a program of auditory stimulation and counseling used to assist children, adolescents, and adults with learning and communication disorders. Presents a meta-analysis of data from five research studies evaluating the efficacy of this method in assisting children with such disorders. Suggests that effect sizes favoring…

  10. Efficacy of an Acceptance-Based Behavior Therapy for Generalized Anxiety Disorder: Evaluation in a Randomized Controlled Trial

    ERIC Educational Resources Information Center

    Roemer, Lizabeth; Orsillo, Susan M.; Salters-Pedneault, Kristalyn

    2008-01-01

    Generalized anxiety disorder (GAD) is a chronic anxiety disorder, associated with comorbidity and impairment in quality of life, for which improved psychosocial treatments are needed. GAD is also associated with reactivity to and avoidance of internal experiences. The current study examined the efficacy of an acceptance-based behavioral therapy…